Skilled Nursing Facility PPS

SNF Program Transmittals

The list below shows the transmittals that are directed to the Skilled Nursing Facilities PPS provider community, but the list may not include all instructions for which Skilled Nursing Facilities PPS providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.

File Release Dt Subject
A-00-08.60 N/A CR 1064: Payment Safeguard Review of SNF Prospective Payment Bills--Updated Instructions
A-00-46 08/03/2000 CR 1224: SNF Adjustment Billing: Adjustment to HIPPS Codes Resulting From MDS Corrections
A-00-47.60 08/07/2000 CR 1223: SNF Annual Update: PPS Pricer and Health Insurance PPS (HIPPS) Coding Changes
AB-01-131 N/A CR 1761: Fiscal Intermediary (FI) Instructions on Applying Payment Bans on Skilled Nursing Facility (SNF) Admissions
A-02-057 07/03/2002 CR 2220: Medicare Part A SNF PPS Update
A-02-121 07/03/2002 CR 1224: SNF Adjustment Billing: Adjustments to HIPPS Codes Resulting from MDS Corrections
A-03-075 08/29/2003 CR 2893: Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Update
Transmittal 13 10/2003 Provider Reimbursement Manual, Part 2, Provider Cost Reporting Forms and Instructions,Chapter 35, Form CMS-2540-96
Transmittal 11 10/2003 Provider Reimbursement Manual, Part 2, Provider Cost Reporting Forms and Instructions, Chapter 36, Form CMS-2552-96
Transmittal 68 01/16/2004 CR 3052: New Requirements for CAHs
Transmittal 74 04/23/2004 CR 3150: SNF Certification and Recertification
3291 2004-04-30 Section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Special Adjustment for Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Rates for Acquired Immune Deficiency Syndrome (AIDS)
3252 2004-05-28 Updated SNF Help File Available for Calendar Year 2004
3338 2004-06-10 Revised Updated SNF NO PAY File for July 2004
2453 2004-07-02 SNF CB Requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.
3352 2004-07-09 Temporary SNF Extension
3323 2004-07-20 Additional Clarification of Bill Types 22x and 23x Submitted by Skilled Nursing Facilities (SNFs) With Instructions for Involuntarily Moving a Beneficiary Out of the SNF and Ending a Benefit Period.
3534 2004-10-20 Removal of the Skilled Nursing Facility (SNF) No Pay File
3651 2004-12-23 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2005 for 9 Metropolitan Statistical Areas (MSAs) with New Wage Index Values Effective January 1, 2005
A-00-01.60 N/A CB for SNF Patients When Receiving Outpatient/Emergency Care in a Medicare-Participating Hospital or CAH
AB-00-18.60 N/A Consolidated Billing for SNFs - Balanced Budget Refinement Act of 1999
A-00-88.60 11/22/2000 Fee Schedule and CB and SNF Services
B-00-67.60 11/27/2000 Consolidated Billing for SNF Residents
AB-01-33.60 N/A Delay of Carrier and Intermediary Actions Required in CRs 1256 and 1323, CB for SNF Residents, and Fee Schedule for Part B Residents and Outpatients
AB-01-71.60 N/A Billing for Audiologic Function Tests For Beneficiaries That Are Patients of a SNF
A-01-94.60 N/A Implementation of Fee Schedule for Additional Part B Services Furnished by a SNF or Another Entity Under Arrangements with the SNF
AB-01-158.60 N/A New Common Working File (CWF) Edits and Standard System Responses on SNF Claims
AB-01-159.60 N/A Common Working File (CWF) Reject and Utilization Edits and Carrier Resolution for Consolidated Billing for SNF Residents
A-01-135.60 N/A HCPCS Code Updates and Corrections for SNF Part A PPS Consolidated Billing and SNF Part B Fee Schedule for 2002.
A-01-142.60 N/A Clarification and HCPCs Coding Update: Part B Fee Schedule And CB for SNF Services
B-02-002.60 N/A Notification to Carriers and Providers of SNF CB Coding Information on CMS Web site
A-01-119.60 N/A Correction to Program Memorandum (PM) A-01-94 (CR 1689): Implementation of Fee Schedule for Additional Part B Services Furnished by a SNF or Another Entity Under Arrangements with the SNF
AB-02-021.60 N/A Common Working File (CWF) Unsolicited Response Edit and Carrier Resolution for Consolidated Billing for SNF Residents
AB-02-023.60 N/A Common Working File (CWF) Edits with Unsolicited Responses for SNF Consolidated Billing
AB-02-037.60 N/A Reissue of information in CR 1955, Transmittal AB-02-021, Common Working File (CWF) Unsolicited Response Edit and Carrier Resolution for Consolidated Billing for SNF Residents
AB-02-027.60 N/A Corrections to Program Memorandum (PM) A-01-135 -- Codes Billable by SNFs and Suppliers for SNF Residents
A-02-101 N/A Corrections to: Changes to the PPS & Consolidated Billing for SNF-Update as published in the Federal Register, FY2001 (66 FR 39572, July 31, 2001), and Transmittal A-01-144, December 20, 2001
AB-02-043.60 N/A Corrections to Program Memorandum (PM) A-01-135 -- Codes Billable by SNFs and Suppliers for SNF Residents
B-02-067 N/A Revision to Messages for SNF Consolidated Billing and Implementation of Common Working File (CWF) Edits for Clinical Social Workers (CSWs) for SNF Consolidated Billing
A-02-118 N/A Annual Update of HCPCS Codes Used for SNF Consolidated Billing Enforcemnt, Updated SNF Help File
AB-02-175 N/A Revisions to CWF Edits for SNF Consolidated Billing to Permit Payment for Certain Diagnostic Services Furnished to Beneficiaries Receiving Treatment for ENd Stage Renal Disease (ESRD) at an Independent or Provider-Based Dialysis Facility
2926 2003-10-31 Annual Update of HCPCS Codes used for SNF Consolidated Billing Enforcement
CR 2944 02/06/2004 Implementation of Skilled Nursing Facility Consolidated Billing CWF Edit for Therapy Codes Considered Separately Payable Physician Services
2983 12/08/2003 Revised SNF NO PAY File, Effective January 1, 2004
CR 3070 02/06/2004 Updates to the January 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement
3156 2004-03-19 Revision to Required Messages in Change Request (CR) 2944, Implementation of Skilled Nursing Facility (SNF) Consolidated Billing Edit for Therapy Codes Considered Separately Payable Physician Services
CR 3196 04/30/2004 Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site Other than a Physician's Office or Hospital
3212 2004-05-28 Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Drugs and Electrocardiogram (EKG) Testing Provided During an Ambulance Transport
3248 2004-05-21 Skilled Nursing Facility (SNF) Consolidated Billing: Services Furnished Under an 'Arrangement' With an Outside Entity
3295 2004-05-28 Skilled Nursing Facility Consolidated Billing L Codes - DMERCs and FIs
3277 2004-06-10 Update to the Common Working File Edits for Skilled Nursing Facility (SNF) Consolidated Billing (CB) to Expand the Bypass for Pharmacy Services.
3348 2004-07-09 October Quarterly Update to 2004 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Enforcement.
CR 3427 11/18/2004 Change to the Common Working File (CWF) Skilled Nursing Facility (SNF) Consolidated Billing (CB) Edits for Ambulance Transports to or from a Diagnostic or Therapeutic Site
3535 2004-10-22 2005 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers
CR 3542 11/23/2004 2005 Annual Update of HCPCS Codes for SNF PPS Consolidated Billing
CR 3575 2004-12-10 Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases - Skilled Nursing Facility (SNF) Consolidated Billing (CB) as it Applies to RHC and FQHC Service
CR 3592 2004-12-23 Skilled Nursing Facility (SNF) Consolidated Billing Service Furnished under an ""Arrangement"" with an Outside Entity
3613 2004-12-30 Correction to January 2005 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
CR 3683 01/24/2005 April Quarterly Update to 2005 Annual Update of HCPCS Codes Used for SNF Consolidated Billing Enforcement
CR 3568 11/26/2004 Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills
3308 2004-07-23 Fiscal Intermediary Shared System (FISS) Changes to Allow for Provider Liability Days on Skilled Nursing Facility (SNF) and Swing Bed Facility Inpatient Bills
A-02-060 07/10/2002 Revision to Billing for Swing Bed Services Under SNF PPS
A-02-028 04/16/2002 Upcoming Train-the-Trainer Session for Hospital Swing Bed Facility PPS
A-02-016 02/15/2002 Conversion of Hospital Swing Bed Facilities to the SNF PPS
A-01-09 01/16/2001 Exemption of Critical Access Hospital Swing Bed from SNF PPS
7182 12/17/2010 Additions To and Revisions of Existing G-Codes for the Reporting of Skilled Nursing Services and Skilled Therapy Services in the Home Health or Hospice Setting
5583 05/30/2007 Clarification of Skilled Nursing Facility (SNF) No Pay Billing
7047 01/06/2011 Analysis CR - The Inclusion of Veterans Administration (VA) Skilled Nursing Facility (SNF) claims to the VA Medicare Remittance Advice (eMRA) Process
5636 06/15/07 October Quarterly Update to 2007 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
5597 06/29/2007 IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates
5532 06/29/07 Coverage Requirements for Therapy Services Provided in a Skilled Nursing Facility
5653 07/13/07 Clarification of Skilled Nursing Facility (SNF) Billing Requirements for Beneficiaries Enrolled in Medicare Advantage (MA) Plans
5734 10/19/07 National Uniform Billing Committee (NUBC) Update on Revenue Codes and Corrected Skilled Nursing Facility (SNF) Spell of Illness Chart
7182 02/08/2011 Additions To and Revisions of Existing G-Codes for the Reporting of Skilled Nursing Services and Skilled Therapy Services in the Home Health or Hospice Setting
5840 12/14/2007 Manual Updates to Chapter 6, Skilled Nursing Facility (SNF) Inpatient Part A Billing, for No Payment and Medicare Advantage (MA) Claims
5418 03/30/2007 Medical Review of Skilled Nursing Facility (SNF) Claims Using the MDS QC System Software
5991 05/16/2008 Medical and Other Health Services Furnished to SNF Patients
6030 05/30/2008 Charges to Hold A Bed During SNF Absence
6568 08/28/2009 Medicare Part A Skilled Nursing Facility Prospective Payment System Pricer Update FY 2010
6619 09/04/2009 2010 Annual Update of Healthcare Common Procedure Code System Codes for Skilled Nursing Facility Consolidated Billing Update
6486 09/14/2009 Skilled Nursing Facility Provider Enrollment Revalidation
7002 06/18/2010 October Quarterly Update to 2010 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
7019 07/30/2010 Revised Instructions for Reporting Assessment Dates under the Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), and Swing Bed (SB) Prospective Payment Systems (PPS)
7047 07/30/2010 Analysis Change Request - The Inclusion of Veterans Administration (VA) Skilled Nursing Facility (SNF) Claims to the VA Medicare Remittance Advice (eMRA) Process
7034 08/06/2010 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2011
7004 08/13/2010 5010 Implementation--Processing Additional International Classification of Diseases, 9th Revision-Clinical Modification (ICD-9-CM) Diagnosis and Procedure Codes in Pricer, Grouper, and the Medicare Code Editor (MCE)
7159 09/10/2010 2011 Annual Update of Healthcare Common Procedure Code System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
All 2008 Transmittals 01/01/2008 All Skilled Nursing Facility PPS related Transmittals for 2008
All 2009 Transmittals 01/01/2009 All Skilled Nursing Facility PPS related Transmittals for 2009
6486 08/21/2009 Skilled Nursing Facility Provider Enrollment Revalidation
Transmittal 1450 02/15/2008 Update to the Common Working File CWF to Allow the Posting of Skilled Nursing Facility SNF and Swing Bed SB Claims to the Beneficiarys Spell of Illness When Qualifying Stay Criteria are Not Met
Transmittal 1425 02/01/2008 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2008 for 2 Core Based Statistical Areas (CBSAs) with New Wage Index Values --Correction
7345 03/25/2011 July Quarterly Update to 2011 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
7339 03/25/2011 Manual Clarifications for Skilled Nursing Facility (SNF) Part A Billing
7164 10/28/2010 Revision to Common Working File (CWF) Edit 729K to Deny Claims for Durable Medical Equipment (DME) Furnished to Beneficiaries in a Non-Part A Skilled Nursing Facility (SNF) Stay
7224 11/19/2010 Update to Medicare Deductible, Coinsurance and Premium Rates for 2011
5624 07/17/07 Additional Common Working File (CWF) Editing for Skilled Nursing Facility (SNF) Consolidated Billing (CB)
5688 07/20/07 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update for FY 2008
5597 07/13/07 IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates
6116 07/18/2008 Revision of the Requirements for Denial of Payment for New Admissions (DPNA) for Skilled Nursing Facility (SNF) Billing
6128 07/18/2008 Revision to Skilled Nursing Facility (SNF) Common Working File (CWF) Editing
7338 05/27/2011 Revisions to Ch. 10, Home Health Agency Billing
7444 06/03/2011 October Quarterly Update to 2011 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement
7625 10/27/2011 Revisions to Common Working File (CWF) Edits that Deny Claims for Prosthetics, Orthotics, and Supplies (POS) Furnished to Beneficiaries in a Skilled Nursing Facility (SNF) Stay
7522 08/26/2011 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2012
7552 08/26/2011 2012 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
7567 11/18/2011 Update to Medicare Deductible, Coinsurance and Premium Rates for 2012
7567 12/16/2011 Update to Medicare Deductible, Coinsurance and Premium Rates for 2012
7701 01/13/2012 Allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertification's
7701 01/13/2012 Allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertification's
7503 08/01/2011 Analysis CR - The Inclusion of Veterans Administration (VA) Skilled Nursing Facility (SNF) claims to the VA Medicare Remittance Advice (eMRA) Process
7661 01/27/2012 Analysis of Improper Overpayments to Design Edits to Correct these Overpayments in CWF, MCS, and FISS
7661 02/29/2012 Analysis of Improper Overpayments to Design Edits to Correct these Overpayments in CWF, MCS, and FISS
7701 2012-04-20 Allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertifications
7760 2012-04-27 Systematic Validation of Payment Group Codes for Prospective Payment Systems(PPS) Based on Patient Assessments
7760 2012-07-18 Systematic Validation of Payment Group Codes for Prospective Payment Systems (PPS) Based on Patient Asssessment.
7907 2012-08-02 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2013