If a swing bed facility sends a beneficiary to an acute facility, would the swing bed bill the ambulance charges on their claim?
Yes, since swing bed hospitals are subject to consolidated billing, the swing bed would include the ambulance charges on their claim. The following ambulance transportation and related ambulance services for residents in a Part A stay are not included in the Part A PPS payment. Except for specific exclusions, consolidated billing includes those medically necessary ambulance trips that are furnished during the course of a covered Part A stay. Carriers and intermediaries are responsible for assuring that payment is made only for ambulance services that meet established coverage criteria. In most cases, ambulance trips are excluded from consolidated billing when resident status has ended. The ambulance company then must bill the carrier or intermediary (as appropriate) directly for payment. Listed below are a number of specific circumstances under which a beneficiary may receive ambulance services that are covered by Medicare, but excluded from consolidated billing. The following ambulanc
Related Questions
- If a patient is discharged from an acute care hospital to a Medicare-certified swing bed in a SNF, is the discharge status of 03 correct, or should it be 61?
- What would the next step be for a claim that denied because the beneficiary was in a Skilled Nursing Facility (SNF)?
- How will the OHCA handle payments for a transfer of a patient from an acute care bed to a swing bed?
