Medicare Part A vs Part B in Skilled Nursing Facilities
Last updated May 2026
Part A in an SNF
Part A covers the SNF benefit period, up to 100 days following a qualifying hospital stay, and reimburses through the Patient Driven Payment Model (PDPM). During Part A days, almost all supplies are bundled under consolidated billing.
Part B in an SNF
Part B covers medically necessary supplies and services for residents who are NOT in a Part A stay. This is where SNF supply reimbursement opens up, catheters, ostomy supplies, enteral nutrition, surgical dressings, and more, billed individually under HCPCS codes.
Where SNFs lose revenue
The most common gap: a resident transitions off Part A and continues to receive Part B-eligible supplies, but no one re-evaluates their billing status. Months of billable supply utilization go uncaptured.
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Frequently asked questions
- Not for the same item at the same time. During a covered Part A stay, supplies are bundled into the SNF PPS payment. Part B supply billing applies to residents who are not in a covered Part A stay.
- Billing responsibility shifts. From that date forward, eligible supplies may be billable under Part B, which is why benefit-period tracking matters as much as the clinical record.
- The facility, as the billing provider. That is why we verify benefit status per encounter before a claim is prepared, rather than billing from a supply list.
Related insights
Medicare Part B Splint and Orthotic Billing for Skilled Nursing Facilities
How SNFs bill Part B splints and orthotics under their own NPI: the braces benefit, the three L-code tiers, therapy documentation, and what audits find.
Read articleMedicare Part B Urological Supply Billing for Skilled Nursing Facilities
How SNFs bill Medicare Part B urological supplies under their own NPI: the permanence criterion, catheter HCPCS codes, usual monthly maximums, and MDS Section H.
Read articleMedicare Part B Ostomy Supply Billing for Skilled Nursing Facilities
How SNFs bill Medicare Part B ostomy supplies under their own NPI: coverage rules, HCPCS pouch codes, monthly quantity limits, documentation, and what changes.
Read articlePrimary sources
Part B rules, audit triggers, and reimbursement policy referenced on this page come from the official sources below. Coverage policy changes; confirm current requirements with CMS and your Medicare Administrative Contractor before billing.
- CMS — Skilled Nursing Facility (SNF) Consolidated Billing
- Medicare.gov — What Part B covers
- CMS — Internet-Only Manuals (Medicare Claims Processing Manual, Pub. 100-04)
This page is general educational information, not legal, coding, or compliance advice. Burst does not guarantee reimbursement, claim approval, or any audit outcome.
Reviewed by Eric Hansen, Chief Executive Officer & Founder · August 2026. Benefit-period and consolidated-billing explanations were checked against the Medicare Claims Processing Manual.
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