The Centers for Medicare and Medicaid Services (CMS) last week issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026 update. AHCA has reviewed the proposed rule and developed a summary outlining key provisions and impacts on members. Please note this is for members only and requires an AHCA/NCAL log-in to view.
As a reminder, the proposed rule:
- Would increase SNF PPS rates by 2.8%, or approximately $997 million, beginning October 1, 2025. This is based on the proposed SNF market basket increase of 3.0%, plus a 0.6% market basket forecast error adjustment, and a negative 0.8% productivity adjustment.
- Includes updates to PDPM ICD-10 code mappings and the SNF Quality Reporting Program. There were no proposed changes to the SNF Value-Based Purchasing Program for FY26, but future year changes are proposed for comment.
- Includes a request for information (RFI) for streamlining regulations and reducing administrative burdens. In every Medicare payment rule issued last week, CMS announced this RFI to comply with President Trump’s Executive Order “Unleashing Prosperity Through Deregulation.”
The proposed changes are detailed in the AHCA summary. Please contact
Martin Allen with any questions.