Let’s talk about how payment and FEES billing works for our patients. Medical billing is about as straightforward as molecular geometry. It’s complex, and even more complicated for people who are in nursing homes or residential care facilities.

Since FEES is a speech therapy evaluation, the Centers for Medicare and Medicaid Service Guidelines mandates that billing for FEES is managed just like all other therapy services.

This means we must bill according to the Consolidated Billing Law, so we invoice each residential care facility, not the patient, at the agreed contract price for all completed exams. The service we provide the patient falls under the umbrella of care they receive at the facility, so it is illegal to issue a separate bill to the patient.

FEES is a cost-effective option for facilities. Since it’s performed at the patient’s bedside, FEES eliminates the need for transportation to a hospital for an alternative diagnostic assessment. It also eliminates the need for a companion to accompany the patient. Additionally, our goal at Carolina Speech Pathology is to administer tests efficiently so that we steward time (and money) well. Further, we do not charge for incomplete exams, cancels, or refusals. 

To delve further into the details, here is how FEES is handled by insurance providers:

Medicare Part A: FEES is bundled into the SNF’s global per diem payment for a resident’s covered Part A stay.

Medicare Part B: FEES must be billed by the SNF for its Part B residents. The SNF will receive the allowable reimbursement from Medicare.

Private Insurance Plans: Preauthorization must be arranged with the insurance company prior to scheduling.

To schedule a FEES today or simply learn more about our process, click here.

Want to learn more? Register for our FREE webinar on August 3, “Much Ado about Swallow Studies: The Clinical and Financial Value of Dysphagia Imaging in Skilled Nursing