Long-Term Care

Taking the mystery out of consolidated billing

Billing Alert for Long-Term Care, December 1, 2014

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In the Balanced Budget Act of 1997 (BBA), Congress mandated that payment for the majority of services provided to beneficiaries in a Medicare covered SNF stay be included in a bundled prospective payment made through the Part A Medicare Administrative Contractor (MAC) to the SNF. These bundled services had to be billed by the SNF to the Part A MAC in a consolidated bill?no longer would providers be able to bill separately for those services. Medicare beneficiaries can be in a Part A covered SNF stay, which includes medical services as well as room and board, or they can be in a Part B non-covered SNF stay receiving therapy services.

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