Skilled Nursing Facility (SNF)
A SNF is an institution or a distinct part of an institution, such as a skilled nursing home or rehabilitation center, which is primarily engaged in providing skilled nursing care and related services for residents who require medical or nursing care; or rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and meets the requirements for participation in the Medicare program. For Medicare purposes, the term SNF does not include any institution which is primarily for the care and treatment of mental diseases. While not SNFs per se, hospital Swingbed units are subject to the same coverage criteria as SNFs and utilize SNF benefit days.
SNFs are reimbursed through the SNF Prospective Payment System (PPS), which is based on Resource Utilization Groups (RUGs).
Access the below SNF related information from this page.
- HIPPS Coding for PDPM
- Minimum Data Set (MDS) Calendar-For ARD from 10/01/11 - 09/30/19 [Excel]
- SNF and Swingbed Billing Chart
- SNF Certification and Recertification for Medical Review
- SNF Consolidated Billing (CB) Matrix
- Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM)
- SNF Resource Utilization Groups Adjustment
- Skilled Therapy Services in the SNF PPS Setting
- CMS FFS SNF ABN
- CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 8, Sections 20, 30, 50, 70
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 1, Sections 50.2, 50.2.3, 60
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 6, Sections 10-40, 90, 100, 110
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 7, Sections 10, 20, 40, 50, 80, 90
- CMS Jimmo Settlement
- CMS Skilled Nursing Facility PPS
- CMS SNF Patient Driven Payment Model (PDPM)
- CMS SNF PPS Consolidated Billing
Last Updated Feb 27, 2020
The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.