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US · guidance

CMS Pub. 100-02, ch. 8, § 20.3.1.5

Impact of Consolidated Billing Requirements

activein force · 2026-08-25 – presentas-observed

The SNF may not charge the beneficiary or family members for any services that, in the

absence of a payment sanction, would have been covered under the SNF PPS.

However, the beneficiary is entitled to reimbursement for those services excluded from

the SNF PPS rate. Services excluded from consolidated billing such as outpatient

hospital emergency care and related ambulance service should be billed by the

provider/supplier actually furnishing services, and not by the SNF.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
9aa96d879b595c833de5ae8491f2642e32996e4dfc7b854657ac742c3bf75517
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