FSNFC™ – Fellowship in Skilled Nursing Facility Coding The FSNFC™ – Fellowship in Skilled Nursing Facility Coding is an advanced specialty training program designed to develop expertise in Skilled Nursing Facility (SNF) Coding, PDPM (Patient Driven Payment Model) reimbursement systems, and regulatory compliance within post-acute care settings.

Skilled Nursing Facility coding requires deep understanding of ICD-10-CM diagnosis capture, MDS documentation alignment, HIPPS code assignment, and Medicare Part A billing rules. The FSNFC™ Fellowship provides structured, case-based learning focused on accurate diagnosis sequencing, PDPM component scoring, and audit-ready documentation practices.

This fellowship covers:

Understanding the Patient Driven Payment Model (PDPM) framework

Accurate ICD-10-CM coding impacting PT, OT, SLP, Nursing, and NTA components

Calculation and interpretation of HIPPS Codes

Diagnosis sequencing and clinical category determination

Understanding Section GG functional scoring impact

Compliance with Medicare Part A SNF billing guidelines

Knowledge of Consolidated Billing rules and excluded services

Preventing errors in MDS documentation and reimbursement alignment

Audit readiness under RAC, MAC, and OIG reviews

Differentiating POS 31 vs POS 32 billing considerations

The FSNFC™ – Fellowship in Skilled Nursing Facility Coding goes beyond traditional diagnosis coding and focuses on the integration of clinical documentation, functional assessment data, and reimbursement calculation accuracy.

This program is ideal for:

SNF Medical Coders

MDS Coordinators

Revenue Cycle Professionals

Post-Acute Care Auditors

Healthcare Compliance Specialists

With increasing scrutiny on PDPM scoring accuracy, clinical category assignment, and therapy utilization patterns, advanced SNF coding knowledge is essential for regulatory compliance and financial stability.

The FSNFC™ Fellowship by PMBAUSA LLC prepares professionals to confidently interpret SNF documentation, align coding with PDPM reimbursement logic, and support audit-ready claims submission processes.

This fellowship serves as a strategic pathway for coders seeking specialization in Skilled Nursing Facility Coding, PDPM Compliance, and Post-Acute Care Revenue Optimization.

Course Objectives

The objective of the FSNFC™ – Fellowship in Skilled Nursing Facility Coding is to develop advanced expertise in Skilled Nursing Facility (SNF) Coding, PDPM reimbursement methodology, and regulatory compliance within post-acute care environments.

By the end of this fellowship, participants will be able to:

  • Explain the Patient Driven Payment Model (PDPM) structure and components

  • Assign accurate ICD-10-CM codes impacting PDPM clinical categories

  • Interpret and calculate HIPPS Codes accurately

  • Understand the impact of PT, OT, SLP, Nursing, and NTA components on reimbursement

  • Align diagnosis coding with MDS documentation and Section GG scoring

  • Apply proper Medicare Part A SNF billing guidelines

  • Understand Consolidated Billing rules and excluded services

  • Differentiate billing requirements for POS 31 vs POS 32

  • Prevent PDPM misclassification, overpayment, and underpayment risks

  • Ensure compliance with RAC, MAC, and OIG audit standards

  • Analyze reimbursement impact in post-acute care settings

  • Strengthen audit readiness and documentation defensibility

This fellowship is designed to elevate professionals into SNF Coding and PDPM Specialists with strong regulatory, reimbursement, and compliance proficiency.

Table of Contents

Module-1: Introduction to Skilled Nursing Facilities (SNFs)

SNF in medical coding stands for Skilled Nursing Facility, a licensed healthcare setting that provides short-term skilled nursing care and rehabilitation services to patients recovering from hospitalization, illness, injury, or surgery.

 

A SNF is a facility or part of a facility engaged in providing skilled nursing care and related services. The patients require medical or nursing care or rehabilitation services. The rehabilitation services are for patients that are: 

  • Injured
  • Disabled
  • Sick 

Special care center for patients needing temporary rehab (like PT/OT/Speech) after a hospital stay, where coders use specific codes (ICD-10, CPT) and models like PDPM (Patient-Driven Payment Model) for complex billing, especially for Medicare Part A, focusing on services by skilled nurses/therapists. 

Module-2: SNF Coverage and Reimbursement

Medicare provides specific rules for Skilled Nursing Facility (SNF) coverage under Part A. Understanding these rules is essential for correct ICD 10 CM coding, PDPM assignment, billing accuracy, and compliance. Coders must know when a service qualifies for Part A payment and how documentation supports each element of coverage.

Module-3: SNF - Consolidated Billing CB

Understanding Bundled Payments for Skilled Nursing Facility SNF Patients

Consolidated Billing CB is a fundamental part of the Medicare Part A payment system for Skilled Nursing Facilities. Under the SNF Prospective Payment System PPS, Medicare provides a single bundled payment that covers most services a resident receives during a Part A covered SNF stay. This means the SNF is financially responsible for almost all services delivered to the patient, even when those services are performed by outside providers.

 

Providers or suppliers must:

  • Verify patient Part A or B status and SNF status before providing services
  • Not submit a separate Part B bill to Medicare Administrative Contractors (MACs) for services subject to CB
  • Look to the SNF for service payments subject to CB
  • Inform all patients who get services in a covered Part A stay about CB requirements

Module-4: SNF ICD-10-CM Coding

Primary Diagnosis Coding and Comorbidity Optimization

Accurate diagnosis coding is the foundation of Skilled Nursing Facility reimbursement under PDPM. Coders must understand how ICD 10 CM codes map to PDPM clinical categories, influence case mix components, and support MDS accuracy. This module trains coders to correctly identify the primary diagnosis for a SNF stay and capture all medically relevant comorbidities that impact Nursing, SLP, and NTA scoring.

Frequently Asked Questions

When does the course start and finish?
This course is completely self-paced, so you can begin at any time and set your own pace.
How do I access the course?
Once you sign up, you will receive an email invitation to join the course. You can access the course from any device with a live Internet connection. The course will work on a desktop, laptop, tablet, and smartphone.
What are the advantages of taking this course online?
Online courses provide unparalleled convenience and flexibility. You can take the course anytime and anywhere, on any device you own.
How do I ask questions?
No. FSNFC™ – Fellowship in Skilled Nursing Facility Coding is an independent educational and professional development program developed and issued by PMBAUSA LLC. It is not affiliated with, endorsed by, accredited by, or sponsored by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any federal, state, or international regulatory authority. This fellowship is designed exclusively for academic learning and professional skill enhancement in Skilled Nursing Facility (SNF) coding and PDPM-related reimbursement concepts. Completion of this program does not confer medical licensure, governmental certification, regulatory approval, payer enrollment status, or authorization to submit claims on behalf of any healthcare entity. Participants are responsible for referring to official CMS regulations, Medicare manuals, ICD-10-CM coding guidelines, MDS documentation standards, PDPM technical reports, and payer-specific billing policies for authoritative and current compliance requirements. Regulations and reimbursement methodologies may change, and professionals must rely on official governmental publications for final coding and billing decisions. PMBAUSA LLC provides structured educational training only and does not represent any governmental agency, regulatory body, or reimbursement authority. Enrollment and completion of the FSNFC™ fellowship should be considered a professional upskilling opportunity and not a substitute for official regulatory guidance or statutory compliance obligations.

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