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Get Cms Consolidated Billing Date Form

, is a Medicare Part A covered patient of (name of skilled nursing facility (SNF)) and has been referred to you for professional services. If there are any technical components to the services provided, the services may be the responsibility of the SNF for inclusion under the consolidated billing provisions of the SNF Prospective Payment System (PPS). The PC/TC indicator in the Medicare Physician Fee Schedule (MPFS) will be used in the SNF fee s.

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