April 2021 Quarterly Update to HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

This article tells you about updates to the lists of HCPCS codes that are subject to the consolidated billing (CB) provision of the SNF Prospective Payment System (PPS). Specifically, this quarterly update includes revisions to the Part B SNF CB files for 2021, 2020, 2019, and 2017. These changes to HCPCS codes and Medicare Physician Fee Schedule designations will be used to revise Common Working File (CWF) edits to allow MACs to make appropriate payments in accordance with policy for SNF CB. This policy is contained in the Medicare Claims Processing Manual, Chapter 6, Section 20.6.

Last Updated: 04/02/2021