by Jared Staheli
July 9th, 2015
Inpatient Part A beneficiary - SNF bills the FI under Part A. The service is included in SNF PPS payment.
Inpatient Part B beneficiary (benefits exhausted or no Part A entitlement) - SNFs may provide the service and bill the FI, may obtain the service under arrangement and bill the FI under Part B, or may have agreement with a reference laboratory for the reference laboratory to provide the service and have the reference laboratory bill the carrier under Part B. Regardless of who bills, CMS policy requires that the service be paid under the fee schedule, whether or not the beneficiary is in a Medicare certified bed.
Outpatient Part B - See inpatient Part B beneficiary (benefits exhausted or no Part A entitlement), immediately above.