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CMS-1403-FC
where the SNF resident who receives them is not in a
covered Part A stay.
Thus, for services that SNF residents receive during
the course of a covered Part A stay, the MIPPA’s
designation of a SNF as a telehealth setting effectively
leaves unchanged the scope of the bundled per diem payment
that the SNF PPS makes for the covered stay itself.
Accordingly, the use of telehealth as a vehicle for service
delivery would not serve to bundle types of services (such
as those of physicians) that are otherwise separately
payable under Part B when furnished to such residents, nor
would it serve to unbundle types of services (such as those
of CSWs) that are otherwise included within the bundled SNF
PPS payment.
In order to reflect this conforming amendment, we are
revising the implementing regulations at §411.15(p)(2) to
include an additional clause, which specifies that types of
services that would otherwise be excluded from SNF
consolidated billing when furnished in a face-to-face
encounter are also excluded when furnished via telehealth
under section 1834(m)(4)(C)(ii)(VII) of the Act.
Consistent with the preceding discussion, this revision
serves to clarify that a type of service (such as a
physician service) that is otherwise excluded from SNF
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