CMS Pub. 100-04, ch. 30, § 260.2

The expedited determination process is available to beneficiaries in Original Medicare

whose Medicare covered services are being terminated in the following settings. All

beneficiaries receiving services in these settings must receive a Notice of Medicare Non-Coverage (NOMNC) before their services end: For purposes of this instruction, the term

“beneficiary” means either beneficiary or representative, when a representative is acting

for a beneficiary.

• Home Health Agencies (HHAs)

• Comprehensive Outpatient Rehabilitation Services (CORFs)

• Hospice

• Skilled Nursing Facilities (SNFs)-- Includes services covered under a Part A stay,

as well as Part B services provided under consolidated billing (i.e. physical

therapy, occupational therapy, and speech therapy). A NOMNC must be

delivered by the SNF at the end of a Part A stay or when all of Part B therapies

are ending. For example, a beneficiary exhausts the SNF Part A 100-day benefit,

but remains in the facility under a private pay stay and receives physical and

occupational therapy covered under Medicare Part B. A NOMNC must be

delivered by the SNF when both Part B therapies are ending.

Skilled Nursing Facilities includes beneficiaries receiving Part A and B services in Swing

Beds.