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Coming Soon: NFSS Form Available for People on Medicare Coinsurance

Last updated on 3/2/2021

As of March 25, 2021, the Preadmission Screening and Resident Review (PASRR) Authorization Request for Nursing Facility Specialized Services (NFSS) Form can also be submitted for people who are authorized for Medicare Coinsurance. This authorization will appear as Service Group 1, Service Code 3 in the person’s Medicaid Eligibility Service Authorization Verification (MESAV) record. Before this update, a nursing facility would have been unable to submit an NFSS form for a person with coinsurance and would have to wait until the person was receiving Medicaid daily care, thereby delaying services.

New Error Messages

Error messages on the Long-Term Care (LTC) Online Portal and Electronic Data Interchange (EDI) have been updated to reflect this change. One or more of the following new error messages may display if providers attempt to submit a PASRR NFSS form when the person is not authorized for the appropriate service code:

  • “This CMWC/DME request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the assessment date. Correct the CMWC/DME assessment date or submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form.”
  • "This CMWC/DME request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the date that submission of the NFSS form was attempted. Submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form."
  • “The Occupational Therapy (OT) request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the assessment date. Correct the OT assessment date or submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form.”
  • “The Physical Therapy (PT) request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the assessment date. Correct the PT assessment date or submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form.”
  • “The Speech Therapy (ST) request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the assessment date. Correct the ST assessment date or submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form.”
  • “This Therapy request cannot be processed because the person does not have a Medicaid Daily Care or Medicare Skilled Nursing service authorization for the submitted Provider number as of the date that submission of the NFSS form was attempted. Submit the necessary paperwork to establish the appropriate service authorization before resubmitting the NFSS form.”

In addition to receiving one of these error messages, the NFSS form will not submit without the appropriate service codes.