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CMS Final Rules for SNFs and Inpatient Psychiatric Facilities

The Centers for Medicare & Medicaid Services (CMS) issued a final rule this week updating payment rates for skilled nursing facilities and for inpatient psychiatric facilities​ for fiscal year 2020.

Skilled Nursing Home Facilities, CMS finalized ​

  • A net payment increase of 2.4%, or $851 million, compared to FY 2019. This includes a 2.8% market-basket update, offset by a statutorily required 0.4% productivity reduction.
  • Details to the new SNF payment model that was finalized in last year’s rulemaking. The new model is projected to contribute to substantial payment improvements for hospital​-based SNFs in FY 2020 (12.4% increase for urban and 23.1% increase for rural hospital-based SNFs).
  • A process for updating ICD-10 codes under the new payment model, and a new, more flexible definition for group therapy that aligns with other post-acute settings.
  • Two new quality measures on transfer of patient health information in the SNF Quality Reporting Program, as well as the adoption of several standardized patient assessment data elements. However, CMS did not finalize its proposal to require reporting of patient assessment data for all patients regardless of payer.

Inpatient Psychiatric Facilities, CMS finalized

  • A net payment increase of 1.5%, or $65 million. This includes a 2.9% market-basket update, offset by statutorily required reductions of 1.15 percentage points and a 0.23 percentage point reduction related to the outlier threshold update. The payment update also reflects the revision and rebasing of the market basket using more recent data.
  • FY 2021 payment determination one quality measure on medication continuation following discharge and requests comment on future topics for measurement. will take effect Oct. 1

Both regulations take effect October 1st 2019


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