- Medical Review
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Medical Review Focus Areas
- Announcing Service Specific Post-Payment Audits of Hyperbaric Oxygen (HBO) Services for J6 A Regions: IL, WI, and MN
- Service Specific Post Payment Review of Darbepoetin Alfa Injection, 1 microgram (Non-ESRD Use)
- Announcing Service Specific Post-Payment Audits of Individual Psychotherapy Services for J6 A Regions: IL, WI and MN
- Skilled Nursing Facility Education Center
Coverage Requirements
Eligibility, preadmission, and 30-day transfer are components of coverage requirements for Skilled Nursing Facilities. There are several components to each of the coverage requirements; please utilize the links below to ensure an understanding of each specific requirement.
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 8- Coverage of Extended Care (SNF) Services Under Hospital Insurance
- Code of Federal Regulations section 409.30
- Code of Federal Regulations section 424.20
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 3- Duration of Covered Inpatient Services
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 1- General Billing Requirements
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 6- SNF Inpatient Part A Billing and SNF Consolidated Billing
Reviewed 6/26/2024
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex
Visit our Contact Us page for other methods of submission
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.
Targeted Probe and Educate Manual
The preferred method to submit Medical Records is NGSConnex:
Visit our Contact Us page for other methods of submission.