According to the Centers for Medicare & Medicaid Services (CMS) Skilled Nursing Facility (SNFs) Prospective Payment System (PPS) final rule for Fiscal Year (FY) 2022, SNFs will see an increase in Medicare Part A payments of approximately $410 million in FY 2022. This estimate reflects at $411 million increase from the update to the payment rates of 1.2%. It is estimated that SNFs would lose around $1.2 million due to the proposed reduction to the SNF PPS rates to account for the recent blood-clotting factors exclusion. It is also important to note that these figures do not incorporate the SNF Value-Based Purchasing Program reductions, which are estimated to be $184.25 million in FY 2022.

The final rule also includes a new methodology for recalibrating the Patient Driven Payment Model (PDPM) parity adjustment. This new payment model would be implemented in a budget neutral manner since the currently available data on the model suggests an unintended increase in payments of approximately 5% or $1.7 billion in FY 2020. 

Other policies in the final rule include PDPM ICD-10 code mappings, addition of new quality measures to the SNF Quality Reporting Program, and an expansion of the Value-Based Purchasing Program measure set.


About 3Gen

3Gen Consulting has always been in the forefront when it comes to adding value. We always believe in setting our own standards. What sets us apart is the investment that we make in our people, processes and innovation to provide you with market leading healthcare revenue cycle management services. We work as an extension of our clients’ teams by focusing on their key challenges, aligning with their culture and delivering the best results.

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