Medical Review of Skilled Nursing Facility Prospective Payment System Bills

June 15, 2016

Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) has updated the instructions for the medical review of skilled nursing facility (SNF) Prospective Payment System (PPS) bills. The updated instructions include the following:

Skilled nursing facility qualifying inpatient stay
Types of SNF PPS reviews
Bill review requirements
Bill review process including obtaining records and making a coverage dertermination

To access the updated instructions, please click

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.