Consolidated billing includes physical, occupational, therapies, and speech-language pathology services received from any patient that resides in an SNF. Therefore the SNF must work with suppliers, physicians, and other practitioners.
Physician Services
There are a limited number of services that are excluded from consolidated billing, including services of a physician assistant, nurse practitioner, and clinical nurse specialist when they are not an employee of the SNF and when these clinicians are working in collaboration with a physician or under their direct supervision. You can also get in touch with experts for skilled healthcare facility billing solutions.
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Physicians submit claims to Medicare Part B for services that are excluded from SNF consolidated billing. There are four files in the Part B update for SNF consolidated billing:
File 1: Part A Stay-Physician services
Codes listed are not subject to SNF consolidated billing and should be submitted to Medicare Part B or Durable Medical Equipment contractor, as appropriate.
File 2: Part A Stay-Professional components of services to be submitted with a 26 modifier
The codes listed are not subject to SNF consolidated billing and should be submitted to Medicare Part B for payment consideration.
File 3: Part A Stay-Ambulance
Codes are subject to SNF consolidated billing and will always be denied by Medicare Part B when submitted with a NN, ND, or DN modifier.
File 4: Part B Stay Only – Therapy services
These therapy codes are subject to SNF consolidating billing and will always be denied by Medicare Part B.
These services must be provided and billed under arrangement with the SNF.