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Region

Region D

Issue Title

SNF Consolidated Billing for Therapies During a Part B SNF Stay

Number

 

Description

For Medicare beneficiaries in a SNF Part B stay, therapies are subject to SNF consolidated billing. Outpatient physical therapy, outpatient speech-language pathology services, and outpatient occupational therapy are billable services by the SNF even when another entity renders the services under arrangement with the SNF.

States

AK, AZ, CA, HI, IA, ID, KS, MO, MT, ND, NV, OR,SD, UT, WA, WY, Guam, American Samoa and Northern Marianas

Provider Type

Physician

Date of Service

Claims that have a “claim paid date” which is more than 3 years prior to the Demand Letter date

References

​1) Medicare Claims Processing Manual: CMS Pub 100-04; Chapter 7 § 10.1, 40 and 110.

2) Overview on Skilled Nursing Facility (SNF) Consolidated Billing (CB) 3) Carrier File Explanation SNF Consolidated Billing​​

Date Posted

 

Date Revised

 

More Information

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Attachments

Created at 6/5/2013 10:07 AM by Aaron Gough
Last modified at 6/5/2013 10:36 AM by Aaron Gough