This is from Transmittal 92, the most recent Consolidated Billing update, which can be found at http://www.cms.hhs.gov/manuals/pm_trans/R92CP.pdf
"The following services may be billed separately under Part B by the rendering provider,
supplier, or practitioner (other than the SNF that receives the Part A PPS payment) and
paid to the entity that furnished the service. These services may be provided by any
Medicare provider licensed to provide them, other than the SNF that receives the Part A
PPS payment, and are excluded from Part A PPS payment and the requirement for
consolidated billing, and are referred to as "Major Category III" for consolidated billing
edits applied to claims submitted to FIs.
"--An ambulance trip (other than a transfer to another SNF) that transports a
beneficiary to the SNF for the initial admission or from the SNF following a final
discharge."
See the transmittal for more information about medically necessary ambulance trips that are excluded when they are provided in conjunction with other excluded services.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: Who pays?
Date: 3/17/04 6:39:07 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
I posted this question a few days ago and didn't get any response. Can anyone help?
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>From: <[EMAIL PROTECTED]>
>Date: 2004/03/15 Mon PM 10:10:34 EST
>To: <[EMAIL PROTECTED]>
>Subject: cost of transportation to hospital
>
>My administrator has asked that I put this to the group: when we discharge someone to the hospital and they are admitted, who pays for the cost of transportation to the hospital? If they go out on the 5th, the last covered day is the 4th and we cannot bill for the 5th, as the hospital bills for that day. He doesn't feel that the facility should pay for the trip since we are not getting reimbursed at whatever the RUG level is for that day. I know that if we send someone to E.R. and they are not admitted and return to us we bear the cost. How do other facilities handle this? Thanks in advance.
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