The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2027. Effective October 1, 2026, CMS is proposing a 2.4% increase to Medicare Part A rates. This is based on the proposed SNF market basket increase of 3.3%, minus a 0.9% productivity adjustment. This net update will vary geographically. Other proposed changes include:
- SNF Quality Reporting Program (QRP) Updates:
- The rule finalizes removal of two measures starting in FY 2028: 1) The COVID-19 Vaccination Coverage among Healthcare Personnel measure, and 2) The COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measure.
- CMS also finalized a revision to the timeframe for data submission from 4.5 months to approximately 45 days, beginning with the FY 2029 SNF QRP.
- CMS also finalized a significant expansion of the SNF QRP starting with additional reporting requirements in October 2029. SNFs will need to submit MDS information for all residents receiving covered skilled care, regardless of payer, aligning with other post-acute care quality programs.
- SNF Value-Based Purchasing (VBP) Updates:
- CMS provided estimated performance standards for the FY 2029 and FY 2030 program years to comply with the Program’s statutory notice deadline.
- The agency finalized an update to the “snapshot dates” for two MDS-based measures (1. DC Function and 2. Major Injury [Long-Stay]) to maintain alignment with the finalized revisions to SNF QRP submission deadlines for MDS assessment data, beginning with FY 2027 data.
- Request for Information on the Patient Driven Payment Model (PDPM):
- CMS in its proposed rule asked for input on potential updates to PDPM to address Case Mix Upcoding as part of a broader effort to ensure that payment policy reflects current care practices and chances in the SNF resident population. CMS did not provide responses to comments submitted on this RFI in the final rule.
Learn more from the CMS fact sheet and view the final rule in the Federal Register.