Revenue Cycle Management for Skilled Nursing Facilities

Stay up-to-date on skilled nursing regulations along with tips and tricks to improve your medical billing from the experts at MCA.

The Complete Guide to SNF CPT Codes for Stronger Revenue Cycle Management

One of the most common points of confusion in skilled nursing facility billing is where CPT codes fit in the revenue cycle and where they do not. The short answer is this: CPT codes are not part of Medicare Part A SNF billing, which uses revenue codes and HIPPS codes on the UB-04 under PDPM....

Comparing Skilled Nursing Facility Billing and Medical Billing Specialist Roles

Ten years ago, outsourcing nursing home billing was a decision most facilities made reluctantly a response to a vacancy that lasted too long or a billing crisis that could not be resolved internally. The assumption behind in-house billing was that it was the standard, and outsourcing was the...

Why More Nursing Homes Are Choosing Outsourced Billing Services

Ten years ago, outsourcing nursing home billing was a decision most facilities made reluctantly a response to a vacancy that lasted too long or a billing crisis that could not be resolved internally. The assumption behind in-house billing was that it was the standard, and outsourcing was the...

Understanding Medicare Billing Challenges Unique to Skilled Nursing Facilities

Medicare billing in a skilled nursing facility is a different discipline from Medicare billing in a hospital, a physician practice, or a home health agency. The payer is the same. The claim forms the UB-04 is shared with hospitals. But the billing framework, the compliance requirements, and...

Medicare and Medicaid Billing Guidelines Every Nursing Home Administrator Must Know in 2026

Nursing home billing guidelines are not static. They change annually with CMS fee schedule updates, ICD-10-CM coding revisions, PDPM policy refinements, Medicaid managed care program expansions, and the ongoing evolution of Medicare Advantage coverage rules. For a nursing home administrator...

A Complete Nursing Home Billing Solutions Guide for SNF Administrators in 2026

Nursing home billing in 2026 is not the same function it was five years ago. The transition to PDPM in 2019 changed how Medicare calculates daily reimbursement. Medicare Advantage enrolment crossing 50% of Medicare beneficiaries changed who is authorizing coverage and how. Medicaid managed...