Back to home

KBH Knowledge Center

Reimbursement

Reimbursement

KBH Consolidated Billing 2022 Reference Kit 8.15.2022

KBH Consolidated Billing 2022 Reference Kit PDF 8.15.2022

KBH Triple Check Form 1.7.2020

NOMNC Instructions 2014

SNF VBP FAQs March 2022

ABN Instructions English

ABN Instructions English 2023 Word Document

ABN Instructions Spanish 2023 PDF

ABN Instructions Spanish 2023 Word Document

ABN Instructions Spanish 2023 Large Print PDF

ABN Instructions English 2023 PDF

ABN Instructions English 2023 Large Print PDF

ABN Instructions English 2023 Large Print Word Document

ABN Instructions Spanish 2023 Large Print Word Document

Home Health MBPM chapter 7 update 3.25.22 R11296BP

Incident to Med Learn Matters

Incident to NCBH March 2020

Incident To January 2022

Incident To 9.2.2004 CMS

Consolidated Billing in a Skilled Nursing Facility 5 Major Categories 3.17.2022

Case Mix CT Model 4-1-22-Rates

SNF VBP Total Nurse Staff April 2022 Proposed

ABN (Advanced Beneficiary Notice) Bed Rate Disclosure 4.13.22

Proposed Rule FY 2023 SNF PPS Press Release 4.11.22

Proposed Rule FY 2023 SNF PPS Fact Sheet 4.11.22

Proposed Rule FY 2023 SNF PPS 4.15.22

Case Mix CT PPT April 2022

Home Health Medicare Benefit Policy Manual 4.27.2022

OIG Report Medicare Advantage April 2022

Missouri Case Mix Medicaid SNF FY2023

ABN Rate Disclosure 4.13.22

SNF VBP Proposed Total Nurse April 2022

Reimbursement: Reason Codes

Case Mix Montana

Case Mix STRIVE

Billing Medicare Code Edits - Modernization of Payment Software MLN 4761491 April 2022

MDS State RAI Coordinators

ICD-10 PDGM (Home Care) Groupings 2022 5.22.2022

PDPM Prep Meeting Tool: Business Office

PDPM Prep Meeting Tool: Dietary

PDPM Prep Meeting Tool: MDS

PDPM Prep Meeting Tool: Rehabilitation

PDPM Prep Meeting Tool: Social Services

Consolidated Billing 8.25.2022

PDPM Therapy Minutes 7.25.2022

Reimbursement Massachusetts Medicaid Add On Billing Guidance 12.29.2022.pdf

CMS 2017 Annual Update to the Therapy Code List

Core Components 8.9.17

CPT Eval Code Breakdown 1.1.17

CPT Changes January 2017

Drug Classifications (RAI Manual)

Outpatient Therapy Initial Checklist 5.8.18

PPS Tracker V3 12.29.17

Respiratory Flowsheet 3.2.18

Section GG Nursing Focus 8 hour shifts 9.17.19

Triple Check Form 1.7.20

Triple Check: Medicare Part A UB-04 5.18.18

Updated ICD-10 Resource

Appeals and Denied Claims Management

Payment Error Rate Measurement Manual 10.15.2013

Bundled Payment

In Bundled Matrimony: What Post-Acute Care Providers Should do to Survive a Bundled Payment Agreement (Part 1)

Case Mix - CO, RUG-III 34 Grouper

1. CO Medicaid CMI Hierarchy Chart 3.1.18

2. CO Medicaid CMI Facility Use 3.1.18

3. CO RUG-III Classification Grid 3.1.18

4. CO Case Mix Summary Template SAMPLE Reference Tool 3.1.18

Archived: 1. CO Medicaid CMI Hierarchy Chart 12-2-16

Archived: 2. CO Medicaid CMI Facility-Use 12.5.16

Archived 3. CO RUG-III Classification Grid 11.29.16

Archived: 4. CO Case Mix Summary Template SAMPLE Reference Tool 12.13.16

See more

Case Mix CT- (Not Case Mix)

CT Medicaid- Chapter 7 1.13.2010

Case Mix DC, RUG-IV 48 Grouper

4. Case Mix DC Summary Reference Tool 5.9.18

3. Case Mix DC CMI Classification Grid 5.11.18

2. Case Mix DC Medicaid CMI Facility-Use 5.11.18

1. Case Mix DC Medicaid CMI Hierarchy Chart 5.11.18

Case Mix GA, RUG-III 34 Grouper

(GA) CMI Effective Jan 2019

Final Sample GA Case Mix Rate Letter 2.2.18

5. GA Case Mix Rate Letter 7.3.19

4. GA Case Mix Summary Reference Tool 2.28.18

3. GA CMI Classification Grid 11.21.18

2. GA Medicaid CMI Facility Use 7.23.19

1. GA Medicaid CMI Hierarchy Chart 2.28.18

Nursing Facility Services Policy Manual July 2019 (GA)

See more

Case Mix HI, RUG-III 34 Grouper

Hawaii: QI-1810 7.10.18

Hawaii: QI-1809 7.10.18

Hawaii: QI-1804 Long Term Care Eligibility on 83 and DMO 7.10.18

5. HI Case Mix Letter Sample 3.1.18

4. HI Case Mix Summary Reference Tool.3.1.18

3. HI RUG-III Classification Grid 3.1.18

1. HI Medicaid CMI Hierarchy Chart_4.17.20

2. HI Medicaid CMI Facility-Use_4.17.20

See more

Case Mix ID, RUG-IV 48 Grouper

4. ID Case Mix Summary Template SAMPLE Reference Tool 3.1.18

3. ID RUG-III Classification Grid 3.1.18

2. ID Medicaid CMI Facility-Use_3.1.18

1. ID Medicaid CMI Hierarchy Chart_3.1.18

Case Mix IL, RUG-IV 48 Grouper

2. IL Medicaid CMI Facility-Use 3.1.18

1. IL Medicaid CMI Hierarchy Chart 3.1.18

Case Mix IN, RUG-IV 48 Grouper

4. IN Case Mix Summary Template SAMPLE reference tool 3.1.18

3. IN RUG-III Classification Grid 3.1.18

2. IN Medicaid CMI Facility-Use 3.1.18

1. IN Medicaid CMI Hierarchy Chart 3.1.18

Case Mix IA, RUG-III 34 Grouper

4. IA Case Mix Summary Reference Tool 8.1.18 (WIP)

3. IA RUG-III Classification Grid 8.1.18

2. IA Medicaid CMI Facility-Use 8.1.18

1. IA Medicaid CMI Hierarchy Chart 8.1.18

Case Mix KS, RUG-III 34 Grouper

Kansas Manual 6.12.08

Kansas Case Mix State Docs

4. KS Case Mix Summary Template SAMPLE Reference Tool 3.1.18

3. KS RUG-III Classification Grid 3.1.18

2. KS Medicaid CMI Facility-Use 3.1.18

1. KS Medicaid CMI Hierarchy Chart 3.1.16

See more

Case Mix KY, RUG-III 34 Grouper

4. KY Case Mix Summary 4.16.18

3. KY RUG-III Classification Grid 2.26.18

2. KY Medicaid CMI Facility-Use 2.26.18

1. KY Medicaid CMI Hierarchy Chart 2.26.18

Case Mix LA RUG-III 34 Grouper

4. LA Case Mix Summary Template SAMPLE Reference Tool 3.2.18

3. LA RUG-III Classification Grid 3.1.18

2. LA Medicaid CMI Facility-Use 3.1.18

1. LA Medicaid CMI Hierarchy Chart 3.1.18

Case Mix ME, RUG III 44 Grouper

Nursing Facility - Forum Call: Case Mix Maine 11.2019

Case Mix TX, RUG-III 34 Grouper

Case Mix TX: #4 Case Mix Summary

Case Mix TX: #3 Case Mix Classification Grid RUG-IV 48

Case Mix TX: #2 Medicaid CMI Facility Use

Case Mix

Strive Study- Case-Mix Nursing Minutes by RUG-IV Group and Nursing Staff Type 3.17.21

Consolidated Billing

SNF Billing: Patients who had a procedure by a physician practice participating in BPCI. 10.27.14

Home Care

Medicare and Home Health - CMS September 2020

UB04 - Home Health Colorado

Medicaid

Proposed Medicaid Cuts by State 2017

Medicare Part B

Medicare Claims Processing Ch. 1

Medicare Claims Processing Manual Ch 5 Part B

Medicare Claims Processing Manual Ch 7

Medicare Claims Processing Ch 8

Medicare Claims Processing Ch 23 HCPCs Codes SNF

Medicare Claims Processing Ch 25

See more

MMQ

KBH MMQ Tracker 4.15.2021

MMQ Module 2 PowerPoint: 2.22.21

MMQ Massachusetts 7.1.2020

MMQ Instructions 5.26.2009

PDPM

KBH Map-PDPM Conversion MDS Collection OBRA Assessments 11.1.2020

PDPM Nursing Case Mix 9.17.19

PDPM Transition Schedule 9.17.19

PDPM Massachusetts Rates 11.15.2023 KBH9

PDPM Rates Massachusetts 11.20.2023 KBH

PDPM Rates Massachusetts 11.20.2023 KBH2

See more

Proposed Rule

Proposed Rule 4.8.2021

Proposed Rule 7/16/15

Medicare and Medicaid Proposed Rule: Regulatory Changes for Long-Term Care Facilities 7.13.15

RCS (Resident Classification System)

RCS-1 (Resident Classification System) 6.16.17 Webinar

RCS TEP February 2015 PPT

RCS TEP PPT 10.14.16

RUGs

RUG-IV Classification Grid 2.28.18

RUG III Supportive Documentation 3.2.17

RUG-III Classification Grid 9.14.16

Telehealth

Telehealth Visits April 6, 2018

Value-Based Purchasing

FY 2021 SNF VBP Facility Performance

FAQ

CJR Billing and the waiver of 3-day hospital stay requirement

Does Medicare cover paracentisis once a week at outpatient hospital?

Exemption for hospitals whose ortho docs are participating in BPCI?

First day: Is that day of discharge from hospital or SNF?

How does the SNF Bill Under CJR (Comprehensive Joint Replacement)?

If the CJR patient is admitted from the CJR Hospital to any SNF, the 3 day waiver applies, correct?

So would the PPS/RUG/COT factors apply?

Under Medical Record Review, why are MDS assessments coded with Isolation in Section O reclassified to a lower RUG?

What is the Skilled Nursing Facility Value-Based Purchasing Program (SNFVBP)?

What is the Three-Day Skilled Nursing Facility Rule Waiver?

What kind of information is the patient given in regards to this new model. The push is for these patients to be in and out of SNF in 10 days or less and yet they have no idea why we are doing that.

What measures will be used in the SNFVBP Program?

While a resident in a Skilled Nursing Facility, is Paracentesis procedures covered under Medicare Part A for Medicare Part A Beneficiaries?

Why is the CPT Code G0281 being denied For E-stim?

See more