The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS 1765-F) that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2023. In addition, the final rule includes updates for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program for FY 2023 and future years. Here’s a summary of the key provisions, which are effective October 1, 2022:
- CMS estimates that the aggregate impact of the payment policies in this final rule would result in an increase of 2.7%, or approximately $904 million, in Medicare Part A payments to SNFs in FY 2023 compared to FY 2022.
- Patient Driven Payment Model (PDPM) parity adjustment recalibration and changes in ICD-10 code mappings
- Permanent 5% cap on annual wage index decreases
- SNF Quality Reporting Program: compliance date revisions for certain requirements, new influenza vaccination coverage for health care personnel measure, and regulation text revisions
- SNF Value Based Purchasing: not apply the SNF 30-Day All Cause Readmission Measure for the FY 2023 program year and add 3 new measures for FY 2026 & 2027 program expansion years
Source: U.S. Centers for Medicare & Medicaid Services (CMS)
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