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Latest News:
See CMS MDS 3.0 Resources Below.

MDS 3.0 Updates and Resources
MDS 3.0 Manual Link and Training Resources

CMS MDS 3.0/RUG-IV Conference Call and Training Slides Information

CMS Updates and Resources


Quarterly Providers Updates




Document
SNF Medicare Final Rule 2012

 


SNF PPS INFORMATION CENTER
Consolidated Billing Center

 Medicare Payment Liability Grid: List contains information regarding whether services are included or excluded under SNF Medicare Consolidated Billing.
   
CMS Website links
 
Consolidated Billing:
        General Information regarding SNF Consolidated Billing
  
Physician fee schedule:
        Look up cost for the technical portion of Physician visits and procedure
  
Excluded Items from SNF Consolidated Billing:
        Look up excluded services by HCPCS Codes
   Fee Schedules:
 
       
Clinical Laboratory
         
Part B Drug Pricing
        
Ambulance
        
 DME/Durable Medical Supplies DMEPOS 


 


CMS Manual Links


Medicare Benefit Policy Manual:
 Includes SNF PPS Overview and Skilled Services Defined


Medicare Claims Processing Manual:
Includes Consolidated Billing Requirements, Excluded Services, HIPPS Codes and much more



COVERAGE OF SERVICES

www.cms.hhs.gov/manuals/12_snf/sn201.asp

 

Program Integrity Manual: www.cms.hhs.gov/providers/fraud/


HIPPS Codes:
www.cms.hhs.gov/manuals/pm_trans/A0047.pdf

 

 

 


MDS 2.0 MANUAL AND FORMS:

click above for link to CMS website

Link Includes:

All Previous MDS RAI User Manual Updates

All MDS Forms (including MPAF)

Chapter by Chapter Reference of the RAI User's Manual

Draft of MDS 3.0


Access CMS MDS Q.I. and RUG Reports

 

 


ARCHIVE NEWS:

Expedited Determinations and Appeals Process and Forms Information for Medicare Part A Beneficiaries in the SNF:

EXPEDITED APPEAL PROCESS  IN EFFECT JULY 1, 2005: The new expedited appeal process for Medicare Part A residents in the SNF goes into effect July 1st. This process is similar to the Expedited appeals for managed care residents that went into effect January 2004. Resident will have to be notified within 48 hours of termination of benefits to submit expedited appeal to the QIO.  Read Medlearn Matters Article.

SNF PPS Final Rule for RUG Refinement 2006

MEDICARE APPEALS PROCESS EFFECTIVE 05/01/05
-
CMS has released the new appeals process. A new step has been added. What was perviously known a reconsideration will now be referred to as redetermination and a reconsideration will now be done as the second step to be complete by QIC's.


MDS 2.0 Updates
originally to go into effect on 5/1/05 have been delayed for ongoing review until 6/15/05.
These changes will be added here when available from CMS.

Have you seen the new Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) notice of noncoverage requirements. This will replace current Notice of Non-Coverage/Determination of Continued Stay forms by October 2004.  THIS INFORMATION HAS BEEN POSTED THE CMS WEBSITE.  Final Version remains under review as of 5/15/05 


   
 
 
American Association of Clinical Reimbursement Specialists, Inc     Contact Us: Info@aacrs.com  Phone: (800)804-9206