Only certain chemotherapeutic medications are excluded from SNF PPS. Check the consolidated billing transmittal on the AANAC website, it gives all of the HCPCS codes of the excluded chemo agents. If the med your resident is receiving is listed on the transmittal as an exclusion, then the oncologist's office can bill Medicare directly and the SNF will not be billed. IF, however, the med is NOT listed as an exclusion on the transmittal, then the SNF is responsible for the cost of the medication. I have found that most chemo agents that the oncologists use in my area are NOT exclusions and so are the responsibility of the SNF for payment. Discuss the exclusions with the oncology office prior to the beginning of your resident's treatment. If the oncologist needs to use a med that is not an exclusion, bargain with him to charge the SNF the Medicare Fee Screen rate. The SNF is not responsible for the professional component of the chemo treatment (the doctor's fee).
-----Original Message-----
From: Posey Payne <[EMAIL PROTECTED]>
Sent: Dec 11, 2003 6:30 PM
To: [EMAIL PROTECTED]
Subject:
Where can I find written information regarding who is responsible
for the payment for chemotherapy while a resident is in a skilled
facility under Medicare part A.
Exclusions? Does it matter if the chemotherapy was started prior to
admission?
Thank-you for any help
Linda Payne
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-----Original Message-----
From: Posey Payne <[EMAIL PROTECTED]>
Sent: Dec 11, 2003 6:30 PM
To: [EMAIL PROTECTED]
Subject:
Where can I find written information regarding who is responsible
for the payment for chemotherapy while a resident is in a skilled
facility under Medicare part A.
Exclusions? Does it matter if the chemotherapy was started prior to
admission?
Thank-you for any help
Linda Payne
The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify Linda Payne, R.N., C.R.N.A.C. immediately @ [EMAIL PROTECTED] and destroy all copies of this message and any attachments. Thank you for your cooperation.
