SNFs: Don't Bill Until You Have Submitted MDS

Why This Topic Matters

Billing practices for SNF stays can be affected when required assessments are missing, so facilities need to understand current CMS guidance to avoid improper claims submission and compliance problems.

Article Sections

1. CMS announces a change in its stance on default rates

   Introduces the topic and summarizes the CMS policy issue involving billing when assessments are missing. It frames the discussion around Medicare payment practices for skilled nursing facilities.

2. What the transmittals say

   Reviews the CMS transmittals and the circumstances discussed in the article. It also notes the contrast between current CMS guidance and prior facility practice.

3. How facilities are responding

   Covers general operational steps described for avoiding missed assessments and monitoring the assessment schedule. It includes compliance-oriented workflow suggestions for SNF teams.

4. CMS is still reviewing the issue

   Notes that CMS has not fully resolved the matter and may provide additional clarification later. It closes with the article's discussion of pending agency follow-up.