decisionhealth Newsletters, Answer Books - 2008 Issue 12 (December)
Answer_Book / Site_of_service_Differential / SITE
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Article Overview
This article provides a general overview of Medicare site-of-service payment policy and the distinction between facility and non-facility practice expense valuation. It is relevant to coders, billing staff, and reimbursement professionals who need to understand how place of service can affect payment methodology across common care settings. The discussion is policy-focused and describes the broad categories of services and settings involved.
Why This Topic Matters
Understanding site-of-service payment policy is important because reimbursement may differ depending on whether a service is furnished in a physician office, home, hospital, skilled nursing facility, or ambulatory surgery center. The article helps readers recognize the general framework used to distinguish payment levels across settings.
What You Will Learn
- How Medicare site-of-service payment policy is structured
- The difference between facility and non-facility practice expense valuation
- Which general care settings are treated as facility or non-facility
- Why some services are treated differently based on where they are performed
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle professionals
- Practice managers
- Reimbursement analysts
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