skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email addresses must be separated by a semicolon.]
Last Modified: 11/27/2024 Location: FL, PR, USVI Business: Part B

Skilled nursing facility (SNF) FAQ -- Consolidated billing (Part B)

Q: My claim was denied because the patient was in a skilled nursing facility (SNF) and consolidated billing applies. What is included in consolidated billing?
A: One of the provisions of the Balanced Budget Act (BBA) of 1997 (Section 4432b) requires consolidated billing for SNFs. The consolidated billing requirement confers on the SNF the billing responsibility for the entire package of care residents receive during a covered Part A SNF stay, as well as physical, occupational, and speech therapy services received during a non-covered stay.
A limited number of services are specifically excluded from consolidated billing and therefore separately payable under Part B. These exceptions, as well as additional information concerning SNF consolidated billing, can be found on the CMS website at the CMS SNF consolidated billing webpage external link.
See additional information in our SNF overlap FAQ.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.