Updates to Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Claims

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

MLN Matters Number: MM11992 was posted November 6, 2020 with same title as this blog.

This MLN Matters Article is for Skilled Nursing Facilities (SNFs) and hospital swing bed providers billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.  This article informs you of an update to SNF Patient-Driven Payment Model (PDPM) claims processing instructions to adhere to current Medicare policy. Be sure your billing staff know of this update.  

The official instruction, CR 11992, issued to your MAC regarding this change is available at https://www.cms.gov/files/document/r10448cp.pdf.  If you have questions, your MACs may have more information. Find their website at http://go.cms.gov/MAC-website-list.