MedicaidAdministrativeMedium impact
05-05-2026 Billing Reminder: Skilled Nursing Facilities, ICF-DD and Subacute Care Facilities IM IE LA SAC SD
Molina Healthcare·CA·Claims & Billing
Effective date
May 5, 2026
We identified it
Jun 19, 2026
Summary
Molina Healthcare of California issued billing guidance for Skilled Nursing Facilities, ICF-DD, and Subacute Care Facilities to reduce claim denials. The bulletin identifies four common denial reasons: duplicate service billing, missing authorization, enrollment discrepancies, and invalid revenue codes, with specific recommendations to prevent each type of denial.
Action Required
Immediately: Billing team must implement pre-submission checks for all Molina SNF, ICF-DD, and subacute claims: 1) Verify member eligibility before service and claim submission via availity.com/molinahealthcare/, 2) Check authorization requirements and include authorization numbers on claims, 3) Query original claim status before submitting potential duplicates, 4) Validate revenue codes align with services rendered using current billing guidelines. Failure to follow these practices will result in claim denials and payment delays.