2025 Skilled Nursing Facility Billing Training Guide + Tips to Start

Skilled nursing facility billing is complex, and staying current with evolving Medicare requirements is essential to keeping claims accurate and reimbursements on time.

Whether you're training new staff or reinforcing best practices with seasoned team members, the right education can make a measurable difference in compliance, efficiency, and revenue.

In this article, we’ll cover the basics of skilled nursing facility billing training, where to find the best training courses, and common training mistakes your team should avoid

Why Skilled Nursing Facility billing training is essential

Billing for skilled nursing facilities is complex, fast-moving, and tightly regulated. Medicare rules change often, and each update can affect how you document care, assign codes, and get reimbursed.

Teams need clear, up-to-date guidance on Medicare Part A and B, the Patient-Driven Payment Model (PDPM), and how to complete Minimum Data Set (MDS) assessments correctly. These skills are essential for accurate claims and stable revenue.

As Medicare audits increase, facilities are expected to demonstrate not just proper billing, but a well-documented, reliable process. Training helps staff meet that standard with confidence. It reduces errors, speeds up claim cycles, and protects reimbursement, freeing up time and resources to focus on patient care.

Strong training builds strong systems. And strong systems are what keep your billing efficient, compliant, and ready for whatever changes come next.

What SNF billing involves

SNF billing is built around a detailed process shaped by Medicare rules, care documentation, and time-sensitive forms. Each part of this process, from confirming a resident’s eligibility to submitting the final claim, affects whether your facility gets reimbursed fully and on time.

Medicare Part A and PDPM billing

Medicare Part A coverage for SNFs comes with strict eligibility requirements. A resident typically must have had a three-day inpatient hospital stay and require skilled nursing or therapy services. Once that eligibility is established, reimbursement follows the Patient-Driven Payment Model (PDPM).

PDPM groups residents into case-mix adjusted categories based on five key areas:

• physical therapy (PT)

• occupational therapy (OT)

• speech-language pathology (SLP)

• Nursing

• Non-therapy ancillary (NTA) services

Introduced in 2019 to replace the RUG-IV system, PDPM aims to match payment more closely with patient needs, not just therapy minutes.

Common forms and claims submission steps

Every claim must follow a specific structure. The most common format is the UB-04 form, also known as CMS-1450. Whether submitted on paper or electronically, this form requires supporting documentation, including physician certifications, care plans, and therapy service logs.

Billing also follows a set cycle. Submissions must align with Medicare timelines and include the correct codes and documentation to avoid delays or rejections. Missing even a single required item can disrupt reimbursement.

The role of clinical documentation and MDS

At the center of the billing process is the Minimum Data Set (MDS). These assessments directly influence PDPM reimbursement. The MDS captures a resident’s clinical status, functional abilities, and care needs. That information flows into case-mix classification and ultimately affects payment rates.

Because of its financial and clinical importance, MDS completion must be accurate and timely. Late or incomplete assessments can reduce reimbursement or trigger audits. In most facilities, an interdisciplinary team, including nursing, therapy, and administrative staff collaborates on the MDS to ensure accuracy and compliance.

Well-organized documentation, consistent assessment practices, and a thorough understanding of PDPM all come together in the billing process.

Top sources for SNF billing training

Medicare billing classes and training options for SNF billing professionals have expanded significantly in recent years, giving facilities more ways to keep staff educated and compliant. Whether you're looking to build foundational knowledge or stay updated on the latest changes from CMS, the right training source can make a measurable impact on your team’s performance.

CMS education and official resources

The Centers for Medicare & Medicaid Services (CMS) remains one of the most trusted sources for education on SNF billing. Their SNF Prospective Payment System (PPS) training and Medicare Learning Network (MLN) materials provide authoritative information directly from the source.

CMS also hosts quarterly Open Door Forums, where providers can hear policy updates, ask questions, and get clarity on regulatory expectations. These sessions are especially useful for keeping your billing team aligned with evolving federal standards.

Industry associations and training vendors

Several national organizations specialize in post-acute care education. The American Health Care Association (AHCA) offers webinars, certification programs, and PDPM-specific training. AAPC provides recognized certifications in medical billing and coding that include SNF-relevant content.

For region-specific guidance, MACs like Palmetto GBA offer billing insights tailored to your Medicare Administrative Contractor’s requirements.

Pathway Health, LeadingAge, and HCPro also deliver continuing education programs, with courses ranging from introductory sessions to in-depth billing and reimbursement workshops.

These programs are especially valuable for staff who manage multiple aspects of the revenue cycle or need cross-functional skills.

Certification programs and billing classes

Structured Medicare billing training classes offered online, in hybrid formats, or in person can help codify core skills. Bootcamps, CEU-granting courses, and national certification prep programs support ongoing professional development for billing staff, administrators, and nurses.

Depending on your team’s needs, you can choose self-paced options for maximum flexibility or instructor-led sessions for more structured learning.

Choosing between virtual and in-person learning

Virtual training options are ideal for busy staff, remote teams, or facilities with limited travel budgets. They offer flexibility and often include downloadable materials and session replays.

In-person sessions, on the other hand, can provide more hands-on practice and networking opportunities, particularly for new or transitioning staff. Many providers now offer both formats, allowing you to choose the approach that fits your team’s learning style and availability.

What to look for in a training program

Not all SNF billing programs offer the same depth or relevance. When evaluating a training course, it’s worth looking beyond the syllabus and asking how the content aligns with your facility’s day-to-day challenges. A good program helps your team apply them confidently and correctly.

PDPM and Medicare Part A-specific modules

Training that covers the specifics of PDPM is critical. That includes understanding how MDS assessments feed into case-mix calculations, how to document services that align with Medicare Part A coverage, and how to differentiate between Part A and Part B billing. The more tailored the content is to the SNF setting, the more actionable it will be for your team.

Real-world billing scenarios

Theoretical knowledge only goes so far. Courses that include case studies, error correction exercises, and walkthroughs of actual billing scenarios can help staff build the problem-solving skills needed to manage complex claims. This also helps reduce the likelihood of billing mistakes and prepares teams to spot issues before they escalate.

Post-course assessments and certifications

Look for programs that include quizzes, exams, or other forms of knowledge checks to reinforce learning. Some courses offer certificates of completion, while others prepare participants for national certifications through AAPC, AHIMA, or state-level credentialing bodies.

These credentials not only validate skills but also support staff retention and professional development.

Cost, flexibility, and CEU availability

Course prices can range from a few hundred to over a thousand dollars, depending on the format and depth of instruction. On-demand programs offer flexibility, while scheduled sessions may include more interactive components.

If your staff holds licenses or certifications, check whether the program offers Continuing Education Units (CEUs) that count toward renewal requirements. This adds both practical and professional value to the investment.

Common SNF billing errors training helps avoid

Even small billing mistakes can lead to denials, delayed payments, or audits. Training helps your team spot and prevent these errors before they happen, keeping reimbursements on track and reducing administrative stress.

Watch out for errors like:

• Coding issues: Accurate coding is the foundation of Medicare reimbursement. Misclassifying a patient’s clinical needs or missing a status update can result in underpayments or compliance risks. With regular training, staff stay sharp on PDPM guidelines and avoid outdated or incorrect code use.
  
  

• Missed deadlines: Timely submission matters. Missing a billing cycle or MDS assessment window can mean leaving money on the table. Training reinforces billing schedules and teaches staff how to manage competing priorities without falling behind.
  
  

• Incomplete or missing documentation: Claims often get flagged because a required detail like a physician’s signature, a therapy note, or a complete care plan is missing. Training walks through documentation standards so your team knows exactly what’s needed and when.
  
  

• Overbilling and duplicate submissions: Mistakes like billing for non-covered services or sending the same claim twice can trigger audits. Training helps prevent these errors by teaching staff how to double-check entries and stay aligned with CMS coverage rules.

Frequently asked questions

What does CMS offer for SNF education?

CMS offers a range of free and regularly updated educational resources tailored to skilled nursing facilities. These include the Medicare Learning Network (MLN) web-based training modules, SNF Prospective Payment System (PPS) fact sheets, and quarterly Open Door Forums that provide real-time updates and guidance. 

Are there online SNF billing classes?

Yes, many organizations offer online SNF billing classes, including certification programs, PDPM workshops, and Medicare billing bootcamps. These courses range from beginner-friendly introductions to advanced billing strategy sessions.

How ExaCare supports better billing outcomes

Strong billing outcomes require systems that support accuracy, speed, and informed decision-making at every stage of the admissions process. Even the most well-trained teams can run into delays or errors without the right tools in place. That’s where ExaCare comes in.

While ExaCare isn’t an SNF billing-training platform, it helps your team apply what they’ve learned by making referrals easier to manage, documentation simpler to review, and financial risks easier to assess.

From the moment a hospital sends a referral, ExaCare supports your billing and admissions team with the information they need to act quickly and confidently.

Here’s what ExaCare offers:

• AI-powered referral screening: Reviews hospital packets in minutes, extracting key clinical and financial data so decisions can be made quickly and accurately.
  
  

• Centralized referral management: Brings together referrals from platforms into one interface — no need to toggle between systems.
  
  

• Automated financial analysis: Identifies high-cost medications, runs reimbursement estimates, and flags potential financial risks before admission decisions are made.
  
  

• Built-in analytics: Tracks referral response times, denial reasons, and performance metrics to help you optimize your admissions process and hospital relationships.
  
  

• Integrated communication tools: Enables quick collaboration between staff involved in the intake process, keeping everyone aligned and responsive.

ExaCare equips your team with the operational support needed to turn billing knowledge into smarter admissions and better outcomes. Learn more on the ExaCare blog. 

Interested in seeing how much our tools can help save you time in admissions? Schedule a demo to see how ExaCare can help your facility strengthen referrals and streamline billing decisions.

Schedule a demo.