Wiki Private Pay in Nursing Facility Question

jdazone

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Our practice has a patient who had a SNF stay after a knee replacement and our doc saw the patient at the SNF. Once the patient had recovered to a point where the inpatient SNF stay was no longer a covered Medicare benefit, they chose to pay out of pocket to stay in the SNF for a few more weeks as they didn’t have a great support network at home and wanted to continue their recovery in a nursing home environment. Of course, the SNF was happy to have a private pay patient. When my practice’s physician sees the patient at the facility during their self-pay stay for the ongoing medically necessary management of the replaced knee, what place of service should be billed? Would it still be place of service 31? Or, would it be place of service 32 because the inpatient stay is no longer a covered Medicare benefit? Or, alternatively, is it something other than 31 or 32? Thanks!
 
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