CMS issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2021 update. The final rule includes a net market basket increase of 2.2 percent. AHCA has developed a summary (member login required) of the payment updates, the SNF value-based purchasing program, and the IMPACT Act quality reporting additions.

The final market basket is one tenth lower than the proposed market basket of 2.3 percent due to updated data reflecting substantial changes in the macroeconomic forecast due to 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 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.