Thoughtware

Article 12/01/2017

Prepare for 2018 SNF Part B Payment Changes

Stethoscope on a chart

Skilled nursing facility (SNF) providers are starting the new year with a slight increase in Part B therapy, paid under the physicians’ fee schedule. New rates are effective for service dates beginning January 1, 2018, through year-end. You can download rates for your area from our website.

Therapy and billing staff should also note there were multiple updates to the Current Procedural Terminology (CPT) coding for 2018: codes 97762 and 97532 will be deleted and CPT codes 97763 and G0515 will be added. Software systems used for billing will need to be updated for the CPT changes and rates prior to billing for January dates of service.

Providers also should note the Part B therapy cap for 2018 has been set at $2,010 for the year. As in previous years, occupational therapy has a separate cap of $2,010, while physical therapy and speech therapy share a combined $2,010 cap. Residents with medically necessary services beyond the cap must have services billed with the modifier “KX” or risk being automatically rejected by the Medicare Administrative Contractor.

In addition to updating Part B rates, SNF providers should also note Part A coinsurance for 2018 will change to $167.50 per day for any residents exceeding day 20 of their Medicare Part A benefit periods.

If you have any questions about how these changes could affect your organization, please contact Julie or your trusted BKD advisor.