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CMS Pub. 100-04, ch. 6, § 110.2.4

Edit for Ambulance Services

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

When a medically necessary transport from one SNF to another SNF occurs when the

beneficiary is discharged from the first SNF and admitted to the second, this transport is

included in consolidated billing. The first SNF is responsible for the ambulance service

and the cost is included in the Part A rate. It is not separately billable. CWF will reject

these services to the A/B MAC (B). The A/B MAC (B) must deny the service with

appeals rights.

Effective for claims with dates of service on or after April 1, 2001, CWF implemented

revisions on January 2, 2008 to bypass edit 7275 when a claim with a date of service on

or after April 1, 2001 is submitted and the date of service is within the From/Thru dates

with an occurrence Span code date of 74, 76, 77, 79, or M1 reported on a SNF inpatient

claim 21x in history or the date of service is greater than the occurrence date on a SNF

inpatient claim 21x in history with an occurrence code date of A3, B3, or C3. This will

allow for services to be separately payable outside of SNF consolidated billing during

non-covered periods in the SNF.

History

(Rev. 1757, Issued: 06-19-09, Effective: 07-20-09, Implementation: 07-20-09)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
f888c8303b3b1e208b577802f148df465eaa7d8286800ee17e8256eab20a7bcb
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