02/13/2017

SNF Patients-Proper Billing for Wound Treatments in Office

If a patient is in a rehabilitation center temporarily and the patient comes to our office for wound treatment (99213 and debridements) - can I bill insurance (Medicare) and how do I bill insurance - or CAN I even bill insurance (Medicare or any other ins)- do I have to collect from the rehab center or the patient. Thank you

If a patient is subject to a skilled nursing facility consolidated billing, there are some CPT codes that will be payable to a physician in an office POS and some that will have to be billed to the SNF for payment. Office visits are payable by Medicare even if a patient is subject to SNF consolidated billing. Certain procedures and DME items will be excluded and need to be billed to the facility. Below is a link to the list of procedure codes that will be subject to billing per CMS, updated annually:

https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/2017-Part-B-MAC-Update.html