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Medicare Guide for SNF Billing and Reimbursement, Second Edition

Medicare Guide for SNF Billing and Reimbursement, Second Edition

Item Number: 8545
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Long-term care billers play a vital role in ensuring proper reimbursement for their facility-but that role is not easy. With the new Prospective Payment System (PPS) transforming the long-term care billing landscape, billers need to ensure they are not leaving money on the table. The Medicare Guide for SNF Billing and Reimbursement, Second Edition will help tackle the newest and most complex billing issues.

This guide's second edition highlights the largest change in payment methodology since 1998. On October 1, 2019, the Patient-Driven Payment Model (PDPM) methodology will completely replace the previous RUG-IV system for reimbursement and rate calculations. Offering tables, charts, and tools outlining both case-mix and non-case-mix components that will form SNFs' PPS rates, this book is the perfect referral resource to make sure you and your staff are filing clean claims under PDPM.

In addition to billing for services covered under Medicare Parts A/B and PDPM, this book addresses:

  • No-pay bills
  • Filling out the UB-04
  • SNF consolidated billing
  • Part B outpatient therapy services and billing
  • Billing for medical supplies
  • Billing for diagnostic tests, lab services, and radiology
  • Billing for screening and prevention
  • ICD-10 coding


    This book will help billing staff:

  • Understand the PDPM rate calculation methodology
  • Identify opportunities to maximize reimbursement and accurately project revenue
  • Correctly bill for Medicare Part A and Part B claims
  • Understand how to comply with claims submissions and avoid common billing errors
  • Navigate difficult reimbursement scenarios
  • Effectively communicate with other departments to manage reimbursement and proper documentation

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