SNFs to get $750 million pay boost in 2021


CMS on Friday finalized Medicare payment rates and wage indices for skilled nursing facilities, hospices and inpatient psychiatric facilities for fiscal year 2021.

SNFs will get a $750 million pay boost in fiscal year 2021, amounting to a 2.2% increase from 2020. The rule applies a 5% cap on wage index decreases, tweaks case-mix classification code mappings used under the SNF prospective payment system and adjusts the SNF value-based purchasing program. The latter will decrease annual aggregate payments for value-based models by nearly $200 million.

CMS received a significant number of comments regarding the COVID-19 pandemic, the group and concurrent therapy limit under the Patient Driven Payment Model and other suggested changes to the PDPM case-mix classification model and quality programs under the SNF PPS, but those are outside the scope of the current rule, the agency noted.

The 2.2% hike is less than the 2.7% recommendation in the proposed rule due to slower than anticipated compensation growth amid the pandemic and economic fallout, the CMS said.

Hospice payment rates will increase by 2.4%, which translates to a $540 million bump. Facilities that do not meet quality reporting requirements will receive a 2 percentage-point reduction to their annual pay increases. Annual hospice payments will top out at $30,700. Similar to SNFs, there will also be a 5% cap on wage index decreases.

Inpatient psychiatric facilities will receive a 2.2% pay hike. CMS is also finalizing its proposal to adjust statistical area delineations to better align wage index values with actual labor costs. In addition, the final rule amends scope-of-practice laws to allow advanced practice providers to operate within states’ scope-of-practice laws by documenting progress notes in medical records.



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