Wiki SNF and in office visits

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REllington11

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We are an endocrinologist office. We had an established Medicare patient to come in for an in office visit. Can we treat patient? Does Medicare cover in office visits if patient is in a SNF. Thank you ahead of time for all the wise advise.
 
When admitted for a covered SNF Part A stay, it is called consolidated billing. There are certain services that are part of the consolidated billing, and certain services that are excluded from the consolidated billing. Physician/ACP professional services (like an office visit) are EXCLUDED from consolidated billing and separately payable. Do keep in mind if you are performing any tests that have a professional and technical component, you would bill ONLY the professional component to Medicare. The technical component is billed to the SNF. From personal experience, you may have a hard time getting any payment from the SNF unless you have a contract or approval from them prior.
Here's a good resource to start learning about SNF consolidated billing:
 
Hi Csperoni. Do you use File 1 and File 2 for Part B SNF CB? We are finding that all of the chemotherapy drugs have been removed from the 2024 list. These have been excluded from SNF CB in the past. Have you heard of any major changes on this?
 
schottj said:
Hi Csperoni. Do you use File 1 and File 2 for Part B SNF CB? We are finding that all of the chemotherapy drugs have been removed from the 2024 list. These have been excluded from SNF CB in the past. Have you heard of any major changes on this?
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Sorry - our practice hasn't billed for chemo in at least 10 years, so I'm not up to date on that, but last I was aware chemotherapy was excluded.
 
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