MAR 05, 2021
Billing Injectables to Skilled Nursing Facility
Question: Since Medicare states it will not reimburse for injected drugs while the patient is in a skilled nursing facility (SNF), do we bill the full amount to the facility?
Answer: Determine if the patient can wait until they have left the SNF, as the typical stay is 20 days. Otherwise see if you can get a sample drug to use. If you are unable to get it from the SNF, discuss payment amount with the facility prior to injecting. The SNF receives one payment to rehabilitate the patient. From this amount they may not be eager to pay for a drug that you inject in your office.
See the Fundamentals of Ophthalmic Coding for additional information.