NEWS & REFERENCE - CONSOLIDATED BILLING

Program Memorandum AB-98-35

This memo, received from HCFA on June 19, 1998, identifies changes regarding Consolidated Billing for Skilled Nursing Facilities. Consolidated billing is being delayed for services and supplies rendered to residents during a Part A stay at an SNF that is not yet on PPS, and during a Part B stay.

For Part A services (bill type 21X), SNF's already on PPS will not be required to report line item dates-of-service per revenue code for each ancillary their Part A residents receive.

Part B billing for Therapy Services is not affected by this delay. Therapy services must be billed using HCPCS Codes for dates-of-service beginning July 1 and later. As of October 1, line item dates-of-service billing per revenue code line will be required.

Ambulance suppliers can continue to bill for residents in a Part B stay and for residents in a Part A stay at a SNF not on PPS. Some ambulance services may need to be included in Part A billing for facilities on PPS.