REHAB: PTs Working With SNFs Make Key Coding Mistakes

Why This Topic Matters

The topic affects whether services are properly billed and paid, and whether providers avoid payment denials or compliance exposure when working in SNF settings.

Article Sections

1. Consolidated billing and SNF arrangements

   Overview of Medicare billing responsibilities in skilled nursing facilities and the need for a valid arrangement between the facility and outside suppliers.

2. Risks of working without a written agreement

   Discussion of what can happen when services are provided without the required facility agreement and why this creates reimbursement and compliance concerns.

3. Contract elements to consider

   General points raised about what a written agreement should address for outside therapy suppliers working with SNFs.

4. Part A and Part B status in the agreement

   A brief note on including patient coverage status in the contract language or workflow for SNF arrangements.

5. CMS and OIG guidance

   Reference to federal transmittal and audit activity that clarifies the issue and explains why enforcement attention is increasing.