Skilled Nursing Facilities

SNF billing follows consolidated billing rules for Medicare Part A stays, with Part B for outpatient services. quantumX can manage these processes, ensuring proper use of modifiers and compliance with the 3-day hospital stay requirement for coverage.

SNF billing follows consolidated billing rules under Medicare Part A, as mandated by the Balanced Budget Act of 1997, where the SNF bills for most services during a covered stay. Medicare Part B covers outpatient services like physician visits and therapies during non-covered stays, as detailed by CMS. The 3-day qualifying inpatient hospital stay requirement for Part A coverage, with potential waivers under certain Medicare initiatives, is critical. AAPC notes the importance of using modifiers (e.g., EY for no Medicare payment, KX for therapy thresholds) to ensure accurate billing. quantumX can manage these processes, ensuring compliance and maximizing reimbursements for SNFs.