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Skilled Care in a SNF is medically necessary if all of the following criteria are met. provided only on an inpatient basis in a SNF. particular medical needs, and accepted standards of medical practice. reasonable in terms of duration and quantity. for continued care in a Skilled Nursing facility(SNF) .
For a service to be considered medically necessary, it must be reasonable and necessary to diagnosis or treat a patientâs medical condition. When submitting claims for payment, the diagnosis codes reported with the service tells the payer why a service was performed. The diagnosis reported helps support the medical necessity of the procedure.