SNF Billing Guidelines
Last updated May 2026
Documentation essentials
Every Part B supply claim should be backed by: a physician order, a signed certification of medical necessity (when LCD-required), proof of delivery, and a clinical note linking the supply to the diagnosis being treated.
Common code categories
A-codes for ostomy and urological supplies, A-codes for surgical dressings, B-codes for enteral nutrition, J-codes for select drugs and immunosuppressives, E-codes for DME items dispensed under Part B.
Avoidable mistakes
Billing during a Part A stay, billing without a current physician order, billing the wrong unit count, and billing without an LCD-compliant diagnosis.
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Frequently asked questions
- No. This page summarizes how the rules apply in day-to-day SNF operations. The Medicare Claims Processing Manual, your MAC's LCDs, and current CMS transmittals are the controlling sources.
- Fee schedules update annually, and MAC coverage articles and edits can change mid-year. We review our guidance quarterly and re-verify against the applicable MAC policy before it affects claim preparation.
- The statute does not change, but the A/B MAC administering your jurisdiction publishes its own coverage articles and review targets, so documentation expectations can vary in practice.
Related insights
The Day Part A Ends, Part B Supply Billing Opens
When Part A ends, consolidated billing drops to therapy only and Part B supply billing opens. See which SNF supplies qualify and what each claim needs.
Read articleMedicare Part B Tracheostomy Supply Billing in a SNF: What Pays and What Doesn't
Medicare Part B pays SNFs for trach tubes, inner cannulas and daily care kits once a resident is off Part A. See the codes, the limits and what won't pay.
Read articleMedicare Quantity Limits for SNF Part B Supplies: The 3 Numbers to Check Before You Bill
Medicare limits SNF Part B supply quantities 2 ways: LCD usual maximums and MUEs. See the 3 numbers to check on every claim before it goes out.
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
- CMS — Medicare Coverage Database (LCDs and policy articles)
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 Cara Hansen, Chief Operating Officer · August 2026. Guidance summarized here is re-verified quarterly against current CMS transmittals and MAC coverage articles.
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