Wiki Billing a Nursing Home Discharge and Assisted Living Admission Same Day

[PLDalsoren]

One of the providers I bill for is insisting that he can bill for a skilled nursing facility discharge (99316) and an assisted living admit (99344) for the same patient, same date of service. I know that he can bill a discharge/admit if the patient is being transferred from a hospital to a skilled nursing facility but I'm not finding any information if a transfer from a SNF to assisted living is billable. Does anyone have experience billing this scenario? Can he bill a discharge/admit or should he be billing a follow-up code only to account for the work of both services? Thank you!

 

[sinman0531]

He can bill both, as long as he bills under the appropriate TIN and POS. Then depending on how he gets paid he may or may not actually get paid for both….because the SNF will not get paid for discharge day, only the admitting ALF.

 

[kbartrom]

The codes for assisted living are similar to the codes for office/outpatient visits - patients are either new or established. If the provider is able to bill for both services, the assisted living visit would be an established patient visit. Like you, I can find no information regarding the ability to bill for both services. Will update if I find anything.