Billing Under PDPM and the Interrupted Stay Policy

Post-Acute Care
Learning Management and Training

About This Webinar

On October 1, CMS implemented the new PDPM reimbursement system for SNF providers. With any change in payment system also comes questions related to how the new system may impact billing and other regulatory requirements. CMS recently issued three Program Transmittals (R126, R4409, and R261) which provide further clarifications in the areas of billing, physician certifications and recertifications, and the interrupted stay policy.

In this webinar, we present information related to each of these transmittals. In addition, a review of the interrupted stay policy and assessment requirements is presented along with detailed information related to billing an interrupted stay.

Watch this webinar to learn how to:

  • Define SNF Physician Certification and Recertification requirements under PDPM
  • Describe the components of a PDPM HIPPS code
  • Define an interrupted stay and assessment requirements
  • Describe Medicare claim requirements for interrupted stays
  • Identify when default billing may apply


Ron Orth RN, CHC, CMAC

Senior Analyst: SNF Regulations and Clinical Reimbursement, Relias

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