The Advanced Beneficiary Notice of Noncoverage (ABN), form CMS-R-131, is used by nursing facilities when Medicare Part B services are ending and the resident does not agree with the decision. The current form, posted on the FFS ABN webpage, expires on Jan. 31, 2026, but an updated form has not …
Impact of Combined Assessments on SNF APU: How Medicare 5-Day and PPS Discharge Combined Assessments Affect Your Facility’s APU Calculation The Centers for Medicare & Medicaid Services (CMS) has released a one-page resource for SNF providers that illustrates how Medicare 5-Day and PPS Discharge combined assessments can impact the APU …
Key report excerpts re: SNFs: Within the Traditional Medicare program, reducing improper payments remains a challenge. The improper payment rate reported in FY 2024, 7.66 percent, has not decreased from the rates reported in FYs 2022 or 2023. The four categories with the largest dollars in improper payments in FY 2024 …
Listen to this article Your browser does not support the audio element. In today’s skilled nursing facility (SNF) landscape, the director of nursing services (DNS) is critical not only in overseeing resident care but also in supporting the organization’s financial stability and regulatory compliance. Both goals require a strong understanding …
Question: When a resident changes payers from Medicare Advantage to Traditional Medicare, are the Medicare Advantage days subtracted from the Medicare 100-day benefit period? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, days billed under Medicare Advantage are subtracted from the resident’s 100-day benefit period. This AAPACN resource …
Consolidated billing specifies that the SNF is the responsible party for the billing of the entire package of care the resident receives during a covered Part A SNF stay, as well as identifies a limited number of services specifically excluded from consolidated billing, and therefore, separately payable. The Centers for …
The Centers for Medicare & Medicaid Services (CMS) is offering a recorded presentation which describes the new data validation process. This training will support facilities in understanding the purpose and structure of the data validation process including the notification and submission process, required activities for selected SNFs, and where to …
ADD – EFFECTIVE 01/01/2026 Major Category I. B. – Cardiac Catheterization Major Category III. A. – Chemotherapy Major Category III. C. -Radioisotopes and their Administration TERMINATE – EFFECTIVE 01/01/2026 Major Category III. A. – Chemotherapy Major Category III. D. – Customized Prosthetic Devices Downloads From https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2026-part-mac-update
These files include updates for FY 2026. Use these codes for discharges occurring from April 1, 2026 – September 30, 2026, and for patient encounters occurring from April 1, 2026– September 30, 2026. https://www.cms.gov/medicare/coding-billing/icd-10-codes
The AAPACN Physician Certification Tracker tool helps nurse assessment coordinators track physician certification due dates by calculating required timeframes based on user-entered data and displaying upcoming and overdue certifications to support compliance. The accuracy of the tool depends on the accuracy of the information entered, so timely and precise data …
