In order for Medicare to pay for services at a SNF, they must be medically necessary. This requires that the services rendered be “skilled”. This means that the nursing services provided require the skills of a nurse. In other words, services that can be provided by non-skilled personnel, without the supervision and/or services of a licensed nurse, cannot be considered “skilled”.
The same applies for therapy. If the therapy services rendered are such that they do not require the skills of a licensed PT/OT/SLP, then they cannot be considered “skilled”.
There are policies unique to each Medicare contractor (MAC). Where do you practice? (city/state). I can guide you to specific documentation policies for your area.