tci Part B Insider - 2004 Issue 32

Consolidated Billing: Don't Bill Your Carrier For Services You Know Are Bundled

You don't have to obtain a denial from Medicare Part B for a service that you know is included in the consolidated billing program for skilled nursing facilities, the Centers for Medicare & Medicaid Services recently clarified. CMS has already released instructions, clearly stating that the technical component of physician components are the SNF's responsibility, so there's no need to bill your carrier and receive a denial before billing the SNF, officials said at the Aug. 30 Practicing Physicians Advisory Committee meeting. In response to physician complaints that the SNF prospective payment system doesn't include enough reimbursement for physicians'...

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