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Thread: Skilled Facility

  1. #1
    Join Date
    Apr 2007

    Smile Skilled Facility

    AAPC: Back to School
    Hello everyone,

    DO anyone know if Medicare pay according to patients being skilled or non skilled for part b providers. are they set by DRG'S being reported to Medicare by the skilled nursing home? ... Should I refer to the facility reimbursement for skilled patients?


  2. #2
    Join Date
    Apr 2007
    Swainsboro/Statesboro, GA

    Default RUG's

    SNF's are paid by RUG's which is different from DRG's and APC's. This payment system is based on a composite rate, and includes some services but there are also some excluded services that can be billed separately. The Georgia FI always said it is easier to know the excluded services than the included services.

    Here is the link to the SNF site on the CMS website.


    This is for the skilled services only.

    I hope this helps!

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