Billing A Prosthesis When Patient is in a SNF
Learn about the billing requirements for prosthetic devices provided to patients in a Skilled Nursing Facility.
Medicare requires a Skilled Nursing Facility (SNF) to submit claims for all services provided to a resident. Consolidated Billing, as CMS calls it, eliminates possible duplicate claims to Part A and Part B.
There are services and products, defined by HCPCS codes, which are excluded from Consolidated Billing. Meaning, that when a patient is at a Skilled Nursing Facility, they may receive these certain items and the supplier may bill Medicare for the items.
What Does This Mean for You?
To determine which HCPCS Codes are excluded from Consolidated Billing, download the full file here. If you are providing a service that is not listed on the Consolidated Billing sheet, then you must invoice the SNF.
More information about Consolidated Billing can be found here.