CMS Posts Updated SNF Consolidated Billing HCPCS Code Tables

CMS; Skilled Nursing Facilities (SNF); Medicare
 
The Centers for Medicare and Medicaid Services (CMS) has published a quarterly update to the SNF consolidated billing Healthcare Common Procedure Coding System (HCPCS) code tables for calendar year (CY) 2025. These updates will be effective beginning April 1, 2025. 
 
HCPCS codes are ordinarily billed under Medicare Part B payment policies, but due to SNF consolidated billing provisions, the codes on these tables represent services that cannot be billed by any provider other than a SNF during a beneficiary’s SNF stay. Additionally, during Part A covered stay, many of these services are bundled into the Part A SNF prospective payment system (PPS) pre-diem rate and cannot be unbundled and billed to Part B. These tables also list HCPCS codes that meet a limited number of statutory exclusions from the SNF Consolidated billing policy and can be billed separately under Part B. 
   
A general explanation of the major categories of services excluded from SNF CB can be found here.  A listing of all HCPCS coded added or deleted for CY 2025 is listed on the CMS 2025 Part A MAC Update webpage.