Wednesday, July 31, 2019

CMS Issues FY 2020 SNF PPS Final Rule

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining the proposed Fiscal Year (FY) 2020 Medicare prospective payment system rate update and quality reporting requirements for skilled nursing facilities (SNFs). The FY20 final rule establishes a market basket increase of 2.4 percent, a figure statutorily mandated by Congress, and will start October 1, 2019.

The contents of this final rule become effective October 1, 2019. Please note there is NO delay in the scheduled implementation of the Patient-Driven Payment Model (PDPM), which replaces the Resource Utilization Group IV (RUG-IV).

Based on changes contained within this final rule, CMS indicates aggregate payments to SNFs will increase in FY20 by $851 million from payments in FY19. Of note, the final rule codifies the proposed definition of group therapy. The final rule issued today allows groups of between two and six patients starting October 1, 2019.

Furthermore, the final rule made no material changes to the new payment system, the Patient-Driven Payment Model (PDPM). Register for the virtual PDPM training and gain access to PDPM Academy resources, monthly webinars, and past webinar recordings. Be sure to take advantage of our ICD-10 trainings, as well, that are offered for both coders and non-coders.

Finally, make plans to join us at the 70th AHCA/NCAL Convention and Expo, October 13-16 in Orlando. We will offer several education sessions focused on the new payment system, such as PDPM and the Future of SNF Payment and Organizational Success under PDPM: Budgeting to Benchmarking. Convention is a great opportunity to network with your peers and learn best practices from each other.

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