General Question for the Week of August 21, 2017

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.