| Document Date: 2013-08-07 15:31:19
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Company HCPCS / / Facility Skilled Nursing Facility / / IndustryTerm billable services / radioisotope services / Durable medical equipment / ancillary services / End stage renal disease services / prosthetic devices / Psychological services / / MedicalCondition End stage renal disease / ESRD / / MedicalTreatment Radiation therapy / Cardiac catheterization / Chemotherapy / surgery / dialysis / blood transfusion / / Organization Medicare / / Position Physician / psychologist / psychiatrist / Facility Administrator / / Product Aranesp / / Technology Radiation / x-ray / MRI / Chemotherapy / dialysis / / URL www.cms.hhs.gov/providers/snfpps/snfpps_pubs.asp / /
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SNF’s Notice to a Hospital Treating a Beneficiary in a Medicare Part A Stay on an Outpatient Basis (Sample Notification #6) Hospital _____________________________________________ Date: ___________________