Nursing Facility Services (Codes 99304 - 99318)
This transmittal revises the Claims Processing Manual,
Pub. 100-04, Chapter 12, §30.6.13 with the new code changes by the American Medical
Association Current Procedural Terminology (CPT) 2006 for reporting evaluation and
management visits in the skilled nursing facility (SNF) or nursing facility (NF) settings
(codes 99304 - 99306 for the initial visit; codes 99307 - 99310 for subsequent nursing
facility visits and code 99318 for an annual assessment visit) and who may use these
codes. This transmittal identifies the federally mandated visits per the Long Term Care
regulations and also clarifies the "initial visit" definition, medically necessary visits,
"incident to" services, prolonged services, split/shared evaluation and management
services, gang visits,and discharge day management in the SNF and NF settings.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 06, 2006
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.