View the SNF Medicare Inpatient Calculator Results

Use this procedure to view the SNF Inpatient Medicare Calculator results.

  1. Access the Inpatient Medicare Calculator (SNF) results.
    1. Select Go To > Government Payor Research > Medicare > Inpatient Calculator. The Medicare Inpatient Calculator page opens.

      Note: If your facility offers only one type of Medicare inpatient services, the system bypasses this selection page.

    2. Select RUG and click Next. The Inpatient Medicare Calculator (SNF) page opens
    3. Select the appropriate criteria and click Calculate. The Inpatient Medicare Calculator (SNF) results page opens. For more information about the calculation criteria, refer to Use the SNF Inpatient Medicare Calculator.
  2. View the calculation results.

The following table describes each of the fields on the Medicare Inpatient Calculator (SNF) page. For internal users only, the source information is given for some fields, in the format: “Table.Field.” The URL for this page is mcr_SNFcalc_output.asp.

Field

Description

Covered Days

Number of covered days for the listed RUG

Discharge Date

Date patient was discharged; defaults to the current system date. If you enter a specific discharge date, the results are displayed for the closest date available (from data within the system).

Discharge Status

Discharge status code

Error Code

Reason for rejection or return, if applicable

ICD-9 Diagnosis Code 042 on Claim?

Indicates whether ICD-9 diagnosis code 042 (HIV Positive) is on the claim. This diagnosis code can change RUG reimbursement rates. Possible values are Y (Yes) and N (No).

NPI

Facility’s ten-digit National Provider Identification (NPI) number required on all claims

UB-92, FL51; UB-04, FL51

PROVNUM

Reimbursement Type

Reimbursement type, either expected reimbursement or RA, if applicable (the latest RA is shown if there are multiple RAs)

RUG

The Resource Utilization Group (RUG) code on the claim; uses first 3 alphanumeric digits

RUG Rate

The per diem rate for this listed RUG

Total Reimbursement

The calculated reimbursement based on the covered days and RUG rates

Source: Billmast.EXPPAY