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Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Patient-Driven Payment Model (PDPM) Claims Processing Updates to Current Editing

The purpose of this Change Request (CR) is to implement enhancements to current editing to account for claims that have interrupted stays that span two months and also to modify current editing for Occurrence Span Code (OSC) edits to allow for proper claims adjudication.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 21, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.