On April 11, 2022, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2023 proposed rule for skilled nursing facilities for Part A services reimbursed under Patient Driven Payment Model. Comments on the proposed rule must be received by June 10, 2022. To access the proposed rule, click

On April 8, 2021, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2022 Skilled Nursing Facility (SNF) proposed rule. Comments will be accepted on the proposed rule until 5:00pm on June 7, 2021. The proposed rule is schedule to be published in the Federal Register on April 15, 2021. Highlights of the proposed rule include the following: CMS is proposing to update the SNF payment rates by 1.3% CMS is soliciting broad public comments on a potential methodology for recalibrating the PDPM parity adjustment that would account for the potential effects of the COVID-19 PHE

On July 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Skilled Nursing Facility (SNF) Fiscal Year (FY) 2021 final rule titled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Value-Based Purchasing Program for Federal Fiscal Year 2021“. Highlights of the final rule include the following: CMS projects that aggregate Medicare program payments to SNFs will increase by $750 million, or 2.2 percent, for FY 2021 compared to FY 2020. Changes to the ICD-10 code mappings, effective October 1, 2020 to classify SNF patients into payment groups. CMS is finalizing

On April 10, 2020, the Centers for Medicare and Medicaid Services (CMS) released the FY 2021 Skilled Nursing Facility (SNF) proposed rule. To access the Fact Sheet on this proposed rule, click HERE. To access the proposed rule on the Federal Register, click HERE.

The Centers for Medicare and Medicaid Services (CMS) has announced the 2020 Medicare Part A and Part B premiums and deductibles. In this article, I will provide you with what the premiums and deductibles are for 2020 and how the Medicare beneficiaries Part B deductible can impact the annual therapy threshold dollar amount dependent upon was the deductible met before or after they received outpatient physical, occupational and/or speech therapy services. Question What is the 2020 Medicare Part B deductible? Answer Question How does the Part B deductible impact the annual therapy threshold dollar amount? Answer Question What is the

The Centers for Medicare and Medicaid Services (CMS) has released the Fiscal Year 2020 final rule for the Prospective Payment System (PPS) and Consolidated Billing for Skilled Nursing Facilities (SNF). This final rule finalizes the new payment system, Patient Driven Payment Model (PDPM), that goes into effect with dates of service on and after October 1, 2019. In addition, the final rule revises the definition of group therapy under the SNF PPS and updates requirements for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program. To access the final rule, click HERE. In addition, Gawenda Seminars

Due to a recent finding by the Office of the Inspector General (OIG) finding that the Medicare program improperly paid for Skilled Nursing Facility (SNF) services when the Medicare 3-Day inpatient hospital stay requirement was not met, the Centers for Medicare and Medicaid Services (CMS) has developed a Fact Sheet to explain the SNF 3-day rule billing as well as several other resources. To access the Fact Sheet and additional resources, click HERE.

The Centers for Medicare and Medicaid Services (CMS) has released the Skilled Nursing Facility (SNF) fiscal year (FY) 2020 proposed rule. CMS has published a fact sheet that highlights 3 major provisions of the proposed rule that are: The proposed changes to SNF payment policy under the SNF Prospective Payment System (PPS) The SNF Value-Based Purchasing Program (VBP) The SNF Quality Reporting Program (QRP) In FY 2020, CMS expects payments to SNF’s to increase by 2.5% compared to FY 2019. CMS is proposing to change the definition of group therapy in the SNF Part A setting to align with the