I am looking for insight - I work for a healthcare system which includes many different primary care and specialty services in the office setting. Some of our offices see patients who happen to be in a skilled nursing facility. The patients are being brought from the SNF to the provider's office for evaluation and management. Our providers do not go to the SNF, are not employed by the SNF, and do not get paid by the SNF.
Majority of these patients have Medicare Part B, which we bill for our services. Medicare denies our charges because the patient is in a SNF. In similar scenarios for Hospice patients we would append either the GV or GW modifier to indicate we are not employed or paid by Hospice so Medicare would reimburse the charges. Those modifiers, though, are just for Hospice and don't work for the SNF patients. I haven't been able to find a SNF modifier.
We've tried appealing this with Medicare but have been unsuccessful in getting our charges reimbursed. Does anyone have any advice on how this scenario should be handled; is there a modifier to append?
Thanks in advance for any guidance!
Majority of these patients have Medicare Part B, which we bill for our services. Medicare denies our charges because the patient is in a SNF. In similar scenarios for Hospice patients we would append either the GV or GW modifier to indicate we are not employed or paid by Hospice so Medicare would reimburse the charges. Those modifiers, though, are just for Hospice and don't work for the SNF patients. I haven't been able to find a SNF modifier.
We've tried appealing this with Medicare but have been unsuccessful in getting our charges reimbursed. Does anyone have any advice on how this scenario should be handled; is there a modifier to append?
Thanks in advance for any guidance!
