Requesting an exception to Medicare's routine cost limit.
Because many subacute care patients are Medicare beneficiaries, managers of subacute care facilities must be familiar with Medicare reimbursement methods. Medicare reimburses for skilled nursing care--a form of subacute care--based on a "routine cost limit." However, many subacute care skilled nursing facilities exceed the cost limit because they provide more intensive services than those covered by the routine cost limit. Facilities can recover some of their excess costs by filing for an exception to the routine cost limit. Recently revised guidelines for this exception define eligibility, types of costs included, documentation requirements, time frame for filing, and procedure for filing repeat requests.
McCabe
J P
JP
Whitman Group, Huntingdon Valley, PA, USA.
D005377:Financial Management, Hospital / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D011383:Progressive Patient Care / Q000191:economics; D012051:Reimbursement Mechanisms; D012866:Skilled Nursing Facilities / Q000191:economics*; D014481:United States