AHCA: CMS Issues FY 2026 SNF Final Payment Rule
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026. We’re pleased to report that rates will increase by 3.2%, or approximately $1.16 billion, beginning October 1, 2025. This is a slight increase in the final net update as compared to the proposed rule, which was 2.8%. The 3.2% increase is based on:- A 3.3% market basket increase
- Plus, a 0.6% market basket forecast error adjustment, and
- A negative 0.7% productivity adjustment.
- CMS finalized removing four items previously adopted as standardized patient assessment data elements under the social determinants of health category beginning with the FY 2027 SNF QRP:
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- one item for Living Situation (R0310),
- two items for Food (R0320A and R0320B), and
- one item for Utilities (R0330) beginning with residents admitted on or after October 1, 2025, as previously finalized.
- CMS did not change any quality measures.
- CMS also finalized amending the SNF QRP reconsideration policy and process. CMS will allow SNFs to request an extension to file a request for reconsideration and is updating the bases on which CMS can grant a reconsideration request.
- CMS set final performance standards for the FY 2028 and FY 2029 program years to comply with the Program’s statutory notice deadline.
- CMS removed the SNF VBP Health Equity Adjustment that was set to begin in the FY 2027 program year.
- CMS adopted a reconsideration process that will allow SNFs to seek reconsideration of a review and correction request if they are not satisfied with CMS’s decision on that request, beginning with the FY 2027 program year.
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