Questions billers ask › When is occurrence code 22 reported on a Medicare SNF Part A claim?

When is occurrence code 22 reported on a Medicare SNF Part A claim?

Answered from the public Medicare sources on 2026-10-01. 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

“A benefit period ends 60 days after the beneficiary has ceased to be an inpatient of a hospital and has not received inpatient skilled care in a SNF during the same 60-day period. When the SNF resident's health has improved to the point where he or she no longer needs or receives the level of skilled care required for Part A coverage, the SNF must bill one of the two following scenarios: 1. For the resident that leaves the Medicare-certified SNF or DPU: a. Submit a final discharge bill, and b. Any services rendered after the discharge and billed by the SNF should be submitted on a 23x. 2. For the resident that remains in the Medicare-certified SNF or DPU after the skilled level of care has ended: a. Submit the last skilled care claim with an occurrence code 22 to indicate the date active care ended. i.e., date covered SNF level of care ended, and patient status code 30 to indicate the patient is still a resident in the Medicare-certified SNF or DPU; b. Any Part B covered services rendered and billed by the SNF after the skilled care ended should be submitted on a 22x; and c. All therapies must be billed by the SNF on the 22x. For additional instructions on ending a benefit period go to the Medicare General Information, Eligibility, and Entitlement Manual, Chapter 3, §10.4.2.”

Pub 100-04 Ch 6 § 40.7, 40.7 - Ending a Benefit Period
Captured2026-05-24
sha256:5745c7e1…2efe65e0 · Source

What our AI found in the sources

On a Part A-covered SNF claim (bill type 21x), occurrence code 22 reports the date active care ended -- i.e., the date the covered SNF skilled level of care stopped. You use it in three main scenarios: (1) when a resident's skilled level of care ends but they remain in the Medicare-certified facility, you submit the last skilled claim with occurrence code 22 and patient status 30 (still a patient); (2) when billing a benefits-exhaust claim where the level of care drops mid-month and the patient stays in the facility, occurrence code 22 marks the date active care ended so covered days/charges are billed only through that date; and (3) on a demand bill, when the SNF believes covered care has ended but the beneficiary disagrees, occurrence code 22 (paired with condition code 20) documents the date care ended while the beneficiary pursues a coverage determination. In all cases it signals to Medicare systems where to cut off covered billing even though the beneficiary continues residing in the certified bed.

Also cited

Pub 100-04 Ch 6 § 40.8, 40.8 - Billing in Benefits Exhaust and No-Payment Situations
Captured2026-05-24
sha256:5745c7e1…2efe65e0 · Source

Pub 100-04 Ch 6 § 40.9, 40.9 - Other Billing Situations
Captured2026-05-24
sha256:5745c7e1…2efe65e0 · Source

If this comes up on one of your claims

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