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Billing Alert for Long-Term Care (Single Article)
SNFs suffer default billing blues at the hands of CMS
September 2007
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Product Description:
Skilled nursing facility (SNF) billers, do you think you know when you can bill the default rate? CMS gave some surprise information regarding MDS requirements for billing the default rate for Medicare Part A SNF PPS claims.
The agency addressed this and other issues during the SNF/Long-Term Care Open Door Forum in June.
For default rate billing, most SNFs and consultants have interpreted the instruction on p. 2-39 of the Resident Assessment Instrument (RAI) User's Manual to mean that a facility can bill the default rate when it fails to complete a required PPS MDS for any reason.
