Nursing Facility Visits

Definition

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

Explanation

Non-Physician Practitioners (NPPs) may provide services to SNF and NF patients with certain limitations. Only a physician may perform an initial nursing facility service in a SNF. This includes admissions and re-admissions. In an NF, an 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

99318              Annual Nursing Facility Assessment

Coverage

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

Billing and Coding Rules

Download this detailed E/M reference sheet for home visits, domiciliary care visits and nursing facility services, all in one place.

The physician must bill for the initial nursing facility service (the admission) in a skilled nursing facility. While the patient status remains as a covered Part A SNF stay, the physician and NPP may alternate visits. NPPs may bill for subsequent nursing home services before or after the physician has performed the admission.

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