Questions billers ask › Can you bill Part B for glucose tests during a SNF Part A stay?

Can you bill Part B for glucose tests during a SNF Part A stay?

Answered from the public Medicare sources on 2026-09-15. The quoted text is the source; the note beneath it is what our AI found. You decide what applies to your claim.

The rule, word for word

“ESRD, then the laboratory test is considered to be included in the ESRD PPS, is the responsibility of the ESRD facility and is excluded from the SNF PPS. More information regarding renal dialysis services payable under the ESRD PPS is available in Pub. 100-02, chapter 11. Beneficiaries in a SNF Part A stay are eligible for a broad range of diagnostic services as part of the SNF Part A benefit. Physicians ordering medically necessary diagnostic tests that are not directly related to the beneficiary’s ESRD are subject to the SNF consolidated billing requirements. Physicians may bill the A/B MAC (B) for the professional component of these diagnostic tests. In most cases, however, the technical component of diagnostic tests is included in the SNF PPS rate and is not separately billable to the A/B MAC (B). Physicians should coordinate with the SNF in ordering such tests since the SNF will be responsible for bearing the cost of the technical component. A patient’s physician or practitioner may order a laboratory test that is included on the list of items and services subject to consolidated billing edits for reasons other than for the treatment of ESRD. When this occurs, the SNF CB applies. 40.7 - Billing for Noncovered Clinical Laboratory Tests (Rev. 1, 10-01-03) B3-5114.1 Ordinarily, neither a physician nor a laboratory bills the Medicare Program for noncovered tests. However, if [...]”

Pub 100-04 Ch 16 § 40.6.2.3, 40.6.2.3 - Skilled Nursing Facility (SNF) Consolidated Billing (CB) Editing and Separately Billed ESRD Laboratory Test Furnished to Patients of Renal Dialysis Facilities
Captured2026-05-24
sha256:50a3a42c…b428b1cc · Source

What our AI found in the sources

When a beneficiary is in a SNF Part A stay, physicians may order medically necessary diagnostic tests (including glucose tests) that are not directly related to ESRD. Physicians may bill the A/B MAC (B) for the professional component of these tests under Part B. However, in most cases the technical component of diagnostic tests is included in the SNF PPS rate and is not separately billable to the A/B MAC (B) - the SNF is responsible for bearing the cost of the technical component. Physicians should coordinate with the SNF when ordering such tests since the SNF will be responsible for the technical component cost.

Also cited

If this comes up on one of your claims

The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.

Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.

Ask Verbatim your question