On November 6, 2013, CMS issued Pub 100-20, “Informational Unsolicited Response (IUR) or Reject for Ambulance SNF to SNF Transfer.” In an effort to recover overpayments, the RAC program has identified suppliers that were billing ambulance claims improperly under Part B, resulting in some overpayments. The skilled nursing facility that is discharging the beneficiary to another facility is responsible for the transportation fees. Ambulance providers should seek payment from the transferring SNF.
As per CMS policy: “Ambulance transportation and related ambulance services for residents in a Part A stay are included in the SNF PPS rate and may not be billed as Part B services by the provider.”