How should RHC services furnished to SNF residents be billed?
Effective January 1, 2005, Section 410 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) amended the SNF consolidated billing law to specify that when a SNF’s Part A resident receives the services of a physician (or another type of practitioner that the law identifies as being excluded from SNF consolidated billing) from an RHC, those services are not subject to CB merely by virtue of being furnished under the auspices of the RHC. Accordingly, under section 410 of the MMA of 2003, services otherwise included within the scope of the RHC services that are also described in clause (ii) of section 1888(e)(2)(A) are excluded from consolidated billing, effective with services furnished on or after January 1, 2005. Only this subset of RHC services may be covered and paid separately when furnished to SNF residents during a covered Part A stay. (Reference: Pub 100-4, Chapter 6, Section 20.1.1 entitled, Physician Services and Other Professional Services Excluded
