The Centers for Medicare & Medicaid Services reminded skilled nursing facilities they need to have a written agreement when they use an outside supplier for certain resident services. Transmittal 183 was sent Friday.

The services in question may need to be billed as “consolidated billing.” This is where the facility submits to a Medicare intermediary almost all of the services that a resident receives during a stay covered by Part A, and some under Part B, such as physical and psychological therapies. Also under this umbrella are services that are furnished “incident to” a physician’s service, such as laboratory and other diagnostic tests. The actual physician services are excluded from the consolidated billing.

The transmittal was part of a national re-education campaign about payment responsibilities for beneficiaries in skilled nursing facilities.