General

50.8.1 - General (Rev. 1, 10-01-03) A3-3133.9.A, SNF-230.10.A Other services that are necessary to the health of the patients are covered if the services are generally provided by, or under arrangements made by, skilled nursing facilities. The medical and other health services described in the Medicare Benefit Policy Manual, Chapter 6, “Hospital Services Covered Under Part B,” §§10 - 10.2.4, are generally provided by, or under arrangements made by, skilled nursing facilities and are therefore extended care services. For coverage of diagnostic services and radiological therapy under Part A, the conditions described in §70.1 must be met. Items or services that would not be included as inpatient hospital services if furnished to an inpatient of a hospital are also excluded from coverage as extended care services. For instance, the provision of personal laundry services by skilled nursing facilities is not a covered service under Medicare, since it would not be covered if provided to an inpatient of an acute care hospital. See the Medicare Benefit Policy Manual, Chapter 6, “Hospital Services Covered Under Part B,” §10, for covered inpatient hospital services. The use of an operating room and any special equipment, supplies, or services would not constitute covered extended care services except when furnished to the facility by a hospital with which the facility has a transfer agreement, since operating rooms are not generally maintained by skilled nursing facilities. However, supplies and nursing services connected with minor surgery performed in a skilled nursing facility that does not require the use of an operating room or any special equipment or supplies associated with such a room would be covered extended care services and paid as part of inpatient SNF PPS.