CMS Provides Reminder on Nursing Home Physician Billing

(April 1, 2025) The Centers for Medicare & Medicaid Services (CMS) released a brief outlining the correct billing codes that should be used for physician services provided in nursing homes. The brief suggests that reviews by the Office of the Inspector General suggest instances where the incorrect Place of Service (POS) codes are being used when practitioners submit claims. Specifically, POS code 31 should be used for services provided during a patient’s Medicare Part A stay. POS 32 is for services provided when patients are not in a Medicare stay or have exhausted their Part A coverage. The brief is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841