US · guidance
CMS Pub. 100-04, ch. 6, § 80
Billing Related to Physician’s Services
Normally physicians are responsible for billing for their own services.
The services of facility-based physicians (e.g., those on a salary or percentage
arrangement, lessors of departments, etc., whether or not they bill patients directly)
include two distinct elements - the professional component and the provider component.
The professional component of facility-based physicians’ services includes services
directly related to the medical care of the individual patient. SNFs cannot bill for the
professional components of physician services, these must be billed under a physician
provider number to the A/B MAC (B). The technical component (e.g. the component
representing the performance of the diagnostic procedure itself) of physician services
delivered to SNF inpatients are bundled into the Part A PPS payment and not paid
separately.
A - Podiatry Services
Covered professional services rendered by facility-based podiatrists to individual patients
are covered only as physicians’ services under Part B. Note that certain foot care services
are excluded under both Part A and Part B. Payments to podiatrists for noncovered
services are not allowable Medicare costs regardless of whether the podiatrist’s
professional services are covered under Part B.
History
(Rev. 2245, Issued: 06-16-11, Effective: 08-01-11, Implementation: 08-01-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
86f5b02c953fff984455f004045c5815f99b5712eb391133a7441812a687fcc2
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