PICC and Portable X-Ray Billing

[Asystole RN]

I was curious, are LTC facilities reimbursed by Medicare or other insurances for the insertion of PICCs and the accompanying X-Ray or does the facility have to pay for that out-of-pocket?

[Sam J.]

Here is some general information: https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/index.html

[CapeCodMermaid, RN]

If the patient is skilled, the facility pays for the insertion and the x-ray.

We trained some of our RNs to put PICC line and MID lines in...saves us a ton of $$ since we don't have to call the infusion company or send someone to the ER to have their line put in.

[Sam J.]

Some SNF pharmacies also employ PICC nurses, that are included in the pharmacy contract, or the SNF only pays for their time. With CCM's place having an all-RN staff, and having several PICC nurses, she might easily be saving her place 10's of 1000's of $$ per year over calling in an infusion company or an independent PICC nurse- that can cost several 100 $$ per 'pop'. Not to mention the fact that oh so often IVs are 'found on the floor', and the PICC nurse has to be called back over and over?

[Asystole RN]

For a skilled patient there is 0% reimbursement for PICCs and radiographs? For long term patients is the PICC and radiograph fully reimbursed or only partially?

[Sam J.]

For a skilled patient there is 0% reimbursement for PICCs and radiographs? For long term patients is the PICC and radiograph fully reimbursed or only partially?

There are exceptions to every rule. Best bet- talk to your BOM.