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Fiscal Year 2025 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1802-F)
Fiscal Year 2025 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1802-F)
On July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2025.
CMS is updating SNF payment policies, which would result in a net increase of 4.2%, or approximately $1.4 billion, in Medicare Part A payments to SNFs in FY 2025. In addition to the SNF PPS rate update, CMS is rebasing and revising the SNF market basket to reflect a 2022 base year. CMS is finalizing several changes to the PDPM ICD-10 code mappings and rule changes to CMS’ enforcement policies to impose more equitable and consistent civil monetary penalties (CMPs) for health and safety violations. CMS is finalizing updates to the SNF Quality Reporting Program (QRP) to better account for adverse social conditions that negatively impact individuals’ health or health care by adding four new social determinants of health (SDOH) items and modifying one SDOH assessment item for the SNF QRP. Additionally, CMS is finalizing a policy requiring SNFs included in the SNF QRP to participate in a process to validate data submitted under the SNF QRP beginning with the FY 2027 SNF QRP. The final rule also contains updates to the SNF VBP program.
