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Office ultrasound payment for SNF patient

B

Bwray

Contributor
Messages
23
Location
Wilmington, NC
We are having issues getting Medicare to pay for vascular testing for patients that are in hospice or a SNF. These tests are not related to the hospice or SNF care so Medicare is responsible. We have tried modifiers GW and GV with no success; Medicare still states the facility is responsible and the facility states Medicare is responsible. Any insight?
 
My understanding is if the radiology service is unrelated to the SNF/hospice stay, then Medicare pays only for the professional component portion. The SNF/hospice facility would be responsible for the technical component.
It's been awhile since I've needed to bill for services like this, but you should find the guidelines under the consolidated billing rules.
 
csperoni said:
My understanding is if the radiology service is unrelated to the SNF/hospice stay, then Medicare pays only for the professional component portion. The SNF/hospice facility would be responsible for the technical component.
It's been awhile since I've needed to bill for services like this, but you should find the guidelines under the consolidated billing rules.
Click to expand...
Thank you for answering my question.
 
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