News & Analysis as of

Patient-Driven Payment Model (PDPM) Medicare

King & Spalding

CMS Issues Fiscal Year 2025 Final Rule for Skilled Nursing Facilities

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On July 31, 2024, CMS issued a final rule (the Final Rule) for fiscal year (FY) 2025 updating Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System (PPS). Under the...more

Sheppard Mullin Richter & Hampton LLP

CMS Takes Steps to Lower SNF Medicare Payment Error Rates

With the Medicare Comprehensive Error Rate Testing program projected error rate for skilled nursing facilities (SNFs) showing a significant increase in 2022 (15.1%, up from 7.9% in 2021), the Centers for Medicare and Medicaid...more

King & Spalding

CMS Seeks Feedback on FY 2023 SNF Prospective Payment System Proposed Rule

King & Spalding on

On April 11, 2022, CMS issued its FY 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule updating Medicare payment policies and rates for SNFs. The proposed rule also includes proposals for the...more

King & Spalding

CMS Issues Four Payment Rules for FY 2022

King & Spalding on

On July 29, 2021, CMS issued final rules for FY 2022 in its yearly update to Medicare payment policies under the Skilled Nursing Facility (SNF) prospective payment system (PPS), Inpatient Rehabilitation Facilities (IRFs) PPS,...more

King & Spalding

CMS Final Rule Updates Medicare Payment Rates and Quality Programs for SNFs

King & Spalding on

On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more

Health Care Compliance Association (HCCA)

As New SNF Payment System Takes Effect, CMS Will Monitor Changes in Therapy, Coding

Starting Oct. 1, per diem payments to skilled nursing facilities (SNFs) will be more generous on the first few days of a Medicare beneficiary’s stay, and then drop as the stay continues. That’s one of the changes under the...more

Baker Donelson

CMS Refines Proposed Changes to SNF Reimbursement with Patient-Driven Payment Model

Baker Donelson on

On May 8, 2018, in its Fiscal Year 2019 (FY 2019) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule, Centers for Medicare & Medicaid Services (CMS) proposed a new case-mix classification system...more

Baker Donelson

CMS Refines Proposed Changes to SNF Reimbursement with Patient-Driven Payment Model

Baker Donelson on

On May 8, 2018, in its FY2019 SNF PPS Proposed Rule, CMS proposed a new case mix classification system that drives Medicare reimbursement for SNF inpatient services. The new system would go into effect on October 1, 2019. CMS...more

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