The SNF billing process differs based on the medical services provided by them. This is partly because the skilled nursing facility billing process is full of nuances. 

For example, when billing for Medicare Part A services, SNFs use the CMS-1450 form but when billing for Part B services, SNFs must use a separate HCPCS code on a TOB 22X claim form with different billing details. 

In the US, Medicare Part A services are more frequently used than Part B. And that is why we will discuss the different requirements in skilled nursing facility billing for Part A services. 

Let’s start. 

For stays at skilled nursing facilities and other medical services covered under Medicare Part A, SNFs usually submit bills at the end of every month. However, skilled nursing facility billing can also be completed before the end of the month if: 

• A patient drops out of a skilled nursing facility 
• The patient’s coverage or medical benefits are exhausted 
• After the patient is discharged 

SNFs must submit their Part A bills using the CMS-1450 form. There are ten important fields on this form. These fields must be filled in accurately for the SNF to receive reimbursement on time. 

The list of fields that must be filled in correctly before submitted bills for Part A are: 

1. Type of Bill: There are two types of bills. One is for inpatient services and the other one is for hospital swing bed services. For inpatient services the 21X code is used, whereas for hospital swing bed services the 18X code is used.
   
2. Statement Covers Period: This field must contain details about the date of admission and the last date of SNF billing.
   
3. Occurrence Code and Date: The occurrence code of 50 with the assessment reference date should be added here.
   
4. Occurrence Span Code: Code 70 should be added in this field with dates for 3 consecutive-day qualifying stays.
   
5. Revenue Code: The revenue code for SNF bills submitted under SNF PPS should be 0022.
   
6. HCPCS or Rate or HIPPS Code: These codes must be mentioned in the same order as that in which the patient received that level of care.
   
7. Unit of Service: The number of covered days should be included here for each of the HIPPS rate codes.
   
8. Total Charges: The total charges for revenue code 0022 are zero.
   
9. Principal Diagnosis Code: The principal diagnosis codes should be ICD-10-CM codes.
   
10. Other Diagnoses: In this field, ICD-10-CM codes for up to 8 different conditions can be added. 

Read More:

Know About the Details of Skilled Nursing Facility Billing 

To learn more about our skilled nursing facility billing best practices, please contact Sunknowledge Services Inc., a HIPAA-compliant healthcare revenue cycle management organization serving US healthcare providers and payers since 2007.