The Centers for Medicare & Medicaid Systems (CMS) has released an updated description of the policy on services excluded from consolidated billing.

Under the Medicare Payment System for Skilled Nursing Facilities, the daily RUG rate paid for residents is generally an all-inclusive rate that covers nursing, therapy, and other ancillary services such as medical equipment and prescription drugs. However, there are exceptions to this policy, known as consolidated billing.

Services excluded from consolidated billing can be provided and billed directly to Medicare by a provider other than the Skilled Nursing Facility. The full list of procedure codes that are not part of consolidated billing can be found here.

One change this year has to do with kidney dialysis services. Under previous practice, Medicare recipients with End-Stage Renal Disease were not subject to consolidated billing, so if they were on a Part A stay the service could be provided by an outpatient dialysis center and billed directly to Medicare. That policy has now been extended to recipients with acute kidney failure, making it easier for Skilled Nursing Facilities to accept those clients for Part A stays since their dialysis services will now be paid separately to the provider of that service.