Wiki Joint Injections at POS 31(Skilled Nursing Facility)

[CarlaA]

I work for a small general practice group of owned by a nurse practitioner and our providers are nurse practitioners. One of my NPs routinely goes to the local SNF to treat and see patients. We have another NP that is basically an orthopedic NP. My SNF NP wants to know if my ortho NP comes to the SNF to perform joint injections, 20610, 20611, etc, can these type of services be submitted to Medicare/Medicaid by the clinic?

 

[thomas7331]

Yes, your providers can bill these services, but just be aware that when you bill with the POS 31, you'll be reimbursed at the facility rate for those procedures, which will be a lower rate because the payment only includes the professional services and does reimburse your practice for any of the 'technical' costs - i.e. the costs of the medications, supplies, staff time and office space - which are part of the SNF's responsibility. If the SNF facility does not provide these items and your providers are using their own office's supplies when they do these procedures, you'll need to decide whether it's worthwhile to bill the SNF an invoice for them and be reimbursed.

 

[CarlaA]

Yes, your providers can bill these services, but just be aware that when you bill with the POS 31, you'll be reimbursed at the facility rate for those procedures, which will be a lower rate because the payment only includes the professional services and does reimburse your practice for any of the 'technical' costs - i.e. the costs of the medications, supplies, staff time and office space - which are part of the SNF's responsibility. If the SNF facility does not provide these items and your providers are using their own office's supplies when they do these procedures, you'll need to decide whether it's worthwhile to bill the SNF an invoice for them and be reimbursed.

Thank you so much! I kind of thought this would be the case but I needed to make sure before I let our administrator know. Again thank you so much!