Wiki E/M visits at SNF-2nd request

[dyoungberg]

Hello,

I'm looking for clarification on billing physician visits in a Skilled Nursing Facility.

1. If patient has Medicare Part A only, can we bill the nursing facility for specialist physician visits made to a patient at the nursing facility's request? We are a part B provider.

I've looked on the Medicare website and can't come up with a clear answer to this.

Thank you

Debbie Y, CPC
Billing Specialist

 

[teresabug]

you should be able to find information under "consolidated billing". No part B means no physician e/m coverage as you know. Some services fall under the SNF reimbursing the dr's for certain things. Most are chemo drugs and things of that nature. I would be billing the patient for rounding done at a SNF if there is not a pre-arranged agreement or if the dr's care does not fall under what is listed for consolidated billing.