Revenue Cycle

Tip: Performing services at a separate facility

Medicare Update for CAHs, July 13, 2011

If an employee of the critical access hospital performs a laboratory service at another facility, be mindful of the bill type that should be used. For example, if a phlebotomist employed by the CAH goes to a skilled nursing facility (SNF) to draw blood for outpatient lab tests, the hospital should bill under TOB 85X (outpatient) and be reimbursed 101% of cost instead of the lesser fee schedule amount associated with TOB 14X (non-patient diagnostic laboratory). <Medicare Claims Processing Manual, Chapter 4, §250.6 >

This tip was adapted from HCPro’s Medicare Boot Camp® - Critical Access Hospital Version.

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