General Question for the Week of August 21, 2017

General Compliance Question of the Week

Question:

I am trying to understand the term “consolidated billing” as it applies to skilled nursing facilities (SNFs). Can you provide some information?

Answer:

Consolidated billing (CB) essentially places with the SNF itself the Medicare billing responsibility for the entire package of services that its residents receive during the course of a covered Part A stay—except for those types of services that appear on a short list of statutory exclusions, which remain separately billable to Part B by the outside entity that furnishes them. CB also applies to physical, occupational, and speech-language therapy services furnished to those SNF residents who are in noncovered stays (e.g., Part A benefits exhausted; no prior qualifying hospital stay). More information about SNF CB can be found at https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/index.html.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.