Wiki Kyphoplasty SNF

[shelley.barrett12]

Hi! We have a doctor that wants to do a kyphoplasty in office (which he normally does), but the patient is in a Part A stay at a SNF. Do we just bill straight medicare for this? Or is the SNF going to be responsible for some portion?

Thank you!

 

[amyjph]

It has to do with consolidated billing and the professional and technical components of services. It's explained here: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/ConsolidatedBilling

For example, an ortho practice might see a SNF patient and the physican services fall under B but the technical component of an X-Ray performed in office would fall under the SNF.