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CAPC Palliative Care Discussion Forum
Social Workers in Palliative Care Settings

Next Reply: Re:Billing under Part B for SW services in SNFs
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Post Billing under Part B for SW services in SNFs
Author: pin78
Date: May 2, 2012 10:33 pm
I am part of an upstart palliative care program that will be servicing patients primarily in the skilled nursing facility environment. I was wondering if it is possible for the LCSW to bill under Part B for mental health services in SNFs. Also, for those of you who have experience billing for clinical social work services under Part B as part of your program, must these services be billed under the LCSW's personal provider number, or is there some way for the social worker to bill under the company's name/provider number. Any clarification would be greatly appreciated. Thank you!
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Re:Billing under Part B for SW services in SNFs (by ChrisHerman on 05/14/2012)
Hello,

I work on hospice & palliative care issues in the NASW national office and spoke with my colleague Mirean Coleman, our clinical social work expert, about your question. According to Mirean, a clinical social worker cannot bill independently under Part B for mental health services provided in SNFs, if Medicare Part A pays for the SNF services. Mirean may be contacted at mcoleman@naswdc.org, should you need additional information regarding clinical social work billing.

NASW and other social work organizations have long advocated for legislation that would allow clinical social workers to bill Medicare Part B for mental health services provided in SNFs. The Clinical Social Work Medicare Equity Act (S. 583) would amend Title XVIII of the Social Security Act to permit direct payment under the Medicare program for clinical social work services provided to SNF residents. The legislation remains part of NASW's advocacy agenda and the Social Work Reinvestment Initiative advocacy agenda(www.socialworkreinvestment.org/2012/SWRI-Update2012.pdf).

Hope this helps.

Chris
Re:Billing under Part B for SW services in SNFs (by ChrisHerman on 05/14/2012)
In responding to this post, I forgot to add this piece of information from my colleague Mirean Coleman (mcoleman@naswdc.org):

In relation to your question about billing under the clinical social worker's personal provider number or company's name/provider number, in SNFs, you can bill as incident to the physician practice, which means billing through the practice, not independently. When billing independently, an individual National Provider Number is required. When billing through a group, a National Provider Number for a group is needed.

Please see my previous post in this thread for additional information about billing for clinical social work services in SNFs.

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