CMS Finalizes SNF Prospective Payment System (PPS) for 2021

The Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1737-F] for Fiscal Year (FY) 2021 that updates the Medicare payment rates and the value-based purchasing program for skilled nursing facilities (SNFs). The rule included an increase net market basket of 2.2%. CMS estimates it would increase Medicare SMF payment by almost $750 million in FY 2021.

CMS is finalizing changes to the ICD-10 code mappings, effective October 1, 2020. CMS encourages stakeholders to continue to provide this essential feedback on the ICD-10 code mappings so that they may continue to improve and refine the payment methodology.

In the FY 2021 SNF PPS final rule, CMS is finalizing updates to the SNF VBP Program regulation text at 42 CFR § 413.338 so that it reflects previously finalized policies. It is also updating the 30-day Phase One Review and Correction deadline for the baseline period quality measure quarterly report. In addition, CMS is announcing performance periods and performance standards for the FY 2023 program year. CMS made no changes to the measures, SNF VBP scoring policies, or payment policies.

The final rule displayed on July 31, 2020, at the Federal Register’s Public Inspection Desk and will be available under “Special Filings” here.