Legion Healthcare Solutions

Skilled Nursing Facility Billing Services

Skilled Nursing Facility (SNF) differs from nursing homes, they cover the care provided by occupational therapists, speech-language pathologists, physical therapists, licensed practical nurses, and common nurses. The list, however, is not exclusive however in some cases Medicare-participating Skilled Nursing Facilities patients are admitted based on Skilled nursing residents. Most people confuse skilled nursing facilities with nursing homes, though nursing homes are skilled nurses they don’t require skilled care.

Skilled Nursing Facility has been confusing and leads to several denials, hence during the Balanced Budget Act of 1997 congress mandated to provide a majority of services under the SNF to be included in a potential payment bundled through a Part A Medicare Administrative Contractor (MAC).
Skilled Nursing Facility Billing Service - Legion Healthcare Solutions USA

Legion Healthcare Solutions (LHS) has always worked towards providing a complete over of payment cycle, however, bundled payment for Medicare Part A leads to reduced reimbursement for payment causes.

“Skilled nursing facilities are separated from other bills, typically when the care is needed when a patient has undergone a certain medical procedures. This brings us to question what would be rates, they are decided by the CMS for such cases.”Medicaid Billing Manager at Legion”

– Certified Coder for Skilled Nursing Facility Billing at LHS

Non-Therapy Ancillaries Urban Centers

– $81.60 / Rural centers – $77.96

Speech-Language Pathology Urban Centers

– $23.16 / Rural centers – $29.18

Physical Therapy Urban Centers

– $62.04 / Rural centers – $70.72

Occupational Therapy Urban centers

– $57.75 / Rural centers – $64.95

Nursing Urban centers

– $108.16 / Rural centers – $103.34

Non-case mix adjusted Urban centers

– $96.85 / Rural centers – 98.64

The above rates are calculated by CMS after reviewing several of the factors that include population condition based on historical analysis. Skilled Nursing Facility rates are periodically updated to keep the fairness in the payment.

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