Health Reform WK-EDGE SNF payments to increase by 2.2 percent for 2021
Friday, August 7, 2020

SNF payments to increase by 2.2 percent for 2021

By Kayla R. Bryant, J.D.

CMS finalized a lower SNF payment increase than originally proposed due to the economic impacts of COVID-19.

In addition to updating the skilled nursing facility (SNF) prospective payment system (PPS) payment rate by 2.2 percent for fiscal year (FY) 2021, CMS’ final rule updates geographic delineations designating urban and rural facilities. The rule also finalizes changes to ICD-10 code mappings under the patient-driven payments model (PDPM) (Final rule, 85 FR 47594, August 5, 2020).

Payment rate. The SNF payment rate increase is half of a percent lower than the proposed rate increase of 2.7 percent. The proposed number was based on a growth rate forecast issued before the economic impacts of the COVID-19 pandemic were known. CMS stated that the lower update was driven by the expected impact to health-related labor markets following the start of the recession. The most recent macroeconomic information used to determine the multifactor productivity adjustment (MFP) required by the Affordable Care Act (ACA) was similarly affected, resulting in no market basket percentage reduction from the MFP. The increase in the SNF payment rate is estimated to increase SNF payments by $750 million in FY 2021.

Rural and federal rates. CMS has chosen to use the Office of Management and Budget’s (OMB) revised delineations in OMB Bulletin No. 18-04 to determine urban or rural facility status.

The finalized unadjusted urban federal rates are:

  • physical therapy (PT): $62.04;
  • occupational therapy (OT): $57.75;
  • speech-language pathology (SLP): $23.16;
  • nursing: $108.16;
  • non-therapy ancillaries (NTA): $81.60; and
  • non-case-mix: $96.85.

The finalized unadjusted rural federal rates are:

  • PT: $70.72;
  • OT: $64.95;
  • SLP: $29.18;
  • nursing: $103.34;
  • NTA: $77.96;
  • non-case-mix: $98.64.

Value-based purchasing updates. CMS had previously established a review and correction deadline for SNF quality measure and performance data that would be made public that would have permitted corrections for any report issued during a calendar year until the March 31 following. Last year’s final rule updated this to a 30-day review and correction after the quarterly report issued in June. This final rule also finalized a 30-day review and correction period following the December quarterly report.

MainStory: TopStory FinalRules AgencyNews InpatientFacilityNews MedicarePartANews ProviderPaymentNews QualityNews ReportingTransparencyNews VBPNews NewsFeed

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