(PPS RESIDENTS)85 to 90%...Med B Residents
Only 10 to 15%...PPS Residents
There are two categories of Medicare Residents in most Skilled Nursing Facilities (SNF's); "PPS" and "non-PPS Residents".
1.) PPS (Med A) Residents:
These Residents are in a designated Medicare A bed and are under the PPS guidelines. Orthotics must be purchased from Clinicare by the facility. The cost of the orthotics is absorbed in the Medicare per diem paid to the facility. PPS Residents account for approximately 10 to 15% of the total resident census.
2.) Non-PPS (Med B) Residents:
These Residents are not under the PPS guidelines. The procedure for providing and billing orthotics is as it was prior to the implementation of PPS. Clinicare provides the needed orthotic and then bills Medicare Part B. This group accounts for the remaining 85 to 90% of the Medicare population.
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