Medicare SNF 3-Day Rule Billing Resource

In a recent report, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) determined that Medicare had improperly paid millions of dollars for skilled nursing facility (SNF) services when the Medicare 3-day inpatient hospital stay requirement was not met.

The Centers for Medicare and Medicaid Services (CMS) has developed the Skilled Nursing Facility 3-Day Rule Billing Fact Sheet to help SNFs bill for post-hospital services correctly. The Fact Sheet provides information on how to apply the 3-day rule, including communicating Medicare SNF services coverage rules, Medicare SNF claims processing, financial responsibility for SNF services when there is no 3-day qualifying inpatient stay, and links to several related resources, including a beneficiary fact sheet entitled Are You a Hospital Inpatient or Outpatient?.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866