Corporate

February 26, 2016 - Revised: 04.07.16

Skilled Nursing Facility: Documentation Required to Bill Speech Therapy Services

When billing for speech therapy services in the Skilled Nursing Facility (SNF) setting, the patient's medical record must contain documentation that supports medical necessity for the service.

  • Patients who are transferred from a covered hospital stay to a SNF must require speech therapy services in the SNF for:
    • A condition that  was treated  during the qualifying hospital stay, or;
    • A condition that arose while in the SNF (for treatment of a condition for which the patient was previously treated in the hospital)
  • If there is no indication in the SNF medical record that the patient is receiving speech therapy services in the SNF for a condition treated during the qualifying hospitalization, speech therapy services should be billed as non-covered.
  • However, if the patient receives speech therapy services for a condition that arose while in the SNF for  treatment of a condition that was previously treated in the hospital, and the need for speech therapy services is documented as medically necessary, the SNF may bill for covered speech therapy services.

Reference: CMS Medicare Benefit Policy Manual (Pub. 100-02) chapter 8, sections 10 & 30.2.2.1External PDF


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