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CMS Issues FY 2021 SNF Final Payment Rule

Posted Jul 31, 20201 min Read

Payment & Reimbursement

On July 31, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule for Fiscal Year (FY) 2021 that updates the skilled nursing facility (SNF) prospective payment system (PPS).

We are pleased to report that the final rule includes a net market basket increase of 2.2%.  The final market basket is one tenth lower than the proposed market basket of 2.3% due to updated data reflecting substantial changes in the macroeconomic forecast as a result of COVID-19 CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $750 million in FY 2021.

CMS issued the Final Rule with only a few changes in the Patient-Driven Payment Model (PDPM) payment policy section.  Updates were limited to nominal additions/deletions of ICD-10 codes used to map the primary reason for SNF stay diagnosis to appropriate PDPM clinical categories from the lists included in the proposed rule.

AHCA/NCAL has developed a summary (member login required) of the payment updates, the SNF value-based purchasing program, and the IMPACT Act quality reporting additions.