Definition

Nursing facility visits are Evaluation and Management services provided in a skilled nursing facility or a long term nursing facility.

Explanation

Only a physician may perform an initial nursing facility service in a SNF. This includes admissions and re-admissions. In an NF, a non-physician practitioner (NPP) who is not employed by the NF may perform an initial nursing facility service IF it is allowed within the NPPs licensure, state scope of practice, state law and if the NPP meets collaboration and supervision requirements. NPPs may perform subsequent nursing facility care prior to or after the initial physician admission.

Codes

99304-99306     Initial Nursing Facility Care

99307-99310     Subsequent Nursing Facility Care

99315-99316     Nursing Facility Discharge

Coverage

Physician services are mandated for patients in a SNF or NF as a condition of the facility’s participation with Medicare.