US · guidance
CMS Pub. 100-04, ch. 6, § 50.2.3
Beneficiary Liability Billing Instructions
The SNF shall file a non-payment bill for noncovered Part A services, using condition
code 21 that indicates beneficiary liability. Services that would have been eligible for
Part A benefits in the absence of sanctions cannot be billed as Part B charges. However,
the SNF may directly bill the beneficiary, family members or other third party insurers
for services provided to that beneficiary.
History
(Rev. 1555; Issued: 07-18-08; Effective Date: 01-01-09; Implementation Date: 01- 05-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
58d3d4cd5095d93d5cd0016fedbc84b9a24f1f6822b3d3362aea454f512250a4
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