Verbatim.

Questions billers ask › What services are included in SNF consolidated billing under Medicare?

What services are included in SNF consolidated billing under Medicare?

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

“As previously discussed, the consolidated billing requirement applies to all services furnished to a SNF resident in a covered Part A stay (other than the excluded service categories described below) and for physical therapy, occupational therapy, and/or speech-language pathology services provided to residents and paid under Part B. Examples of services that are subject to consolidated billing include: • Physical therapy, occupational therapy, and/or speech-language pathology services, regardless of whether they are furnished by (or under the supervision of) a physician or other health care professional (see §1888(e)(2)(A)(ii) of the Act). Physical therapy, occupational therapy, and/or speech-language pathology services (other than audiology services, which are considered diagnostic tests rather than therapy services) furnished to a SNF resident during a noncovered stay must still be billed by the SNF itself. This is known as “Part B” consolidated billing (see §20.5 of this chapter). • Psychological and other services furnished by a clinical social worker; and • Services furnished as an “incident to” the professional services of a physician or other excluded category of health care professional described in §20.1.1 below.”
Pub 100-04 Ch 6 § 10.3, 10.3 - Types of Services Subject to the Consolidated Billing Requirement for SNFs
Captured2026-05-24
sha256:5745c7e1…2efe65e0 · Source

What our AI found in the sources

SNF consolidated billing requires the SNF to bill Medicare for almost all services a resident receives during a covered Part A stay, with a few statutory exclusions. Services subject to consolidated billing include physical therapy, occupational therapy, and speech-language pathology services (regardless of who furnishes them); psychological and other services furnished by a clinical social worker; and services furnished "incident to" the professional services of a physician or other excluded practitioner. During a noncovered stay, only therapy services (PT, OT, and speech-language pathology) are subject to consolidated billing; all other covered services are separately billable.

Also cited

Federal Register, document 2018-09015, Sections 1842(b)(6)(E) and 1862(a)(18) of the Act (B. Consolidated Billing)
Published2018-05-08   Captured2018-05-08
sha256:eb38961e…cdbac182 · Source
Pub 100-04 Ch 6 § 10.4, 10.4 - Furnishing Services that are Subject to SNF Consolidated Billing Under an “Arrangement” With an Outside Entity
Captured2026-05-24
sha256:5745c7e1…2efe65e0 · Source

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