decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 2 (February)
Get SNFs to sign an agreement to pay you for tests, drugs, labs
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Article Overview
This article explains how Medicare consolidated billing affects billing for patients in skilled nursing facilities during a Part A stay. It focuses on why practices should have written reimbursement arrangements with SNFs for covered services that are bundled into the SNF payment, and it discusses the operational impact for physicians, laboratories, and other providers handling tests, drugs, and related services.
Why This Topic Matters
It helps practices avoid improper Medicare billing, understand when payment must come from the SNF instead of Medicare, and recognize why written agreements are important for protecting reimbursement in SNF cases.
What You Will Learn
- How Medicare consolidated billing affects services furnished during a skilled nursing facility Part A stay
- Why written reimbursement arrangements with SNFs are important
- Which broad categories of services are discussed as affected by SNF billing rules
- How the policy affects physician practices, diagnostic services, and drug billing
Who Should Read This
- Physicians
- Medical practice billers and coders
- Compliance staff
- Revenue cycle managers
- Practice administrators
Modifiers Discussed
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