Keep in the Know- Regulatory Updates

Over the last year, the Centers for Medicare and Medicaid Services (CMS) has implemented major payment changes for Therapy Services delivered in skilled nursing facilities (SNFs). Below are a few recent updates:

  • Value-Based Purchasing Program: As you know, on October 1, 2019, CMS shifted to Patient-Driven Payment Model (PDPM) for all SNFs. This value-based payment model supports care decisions made by the interdisciplinary care team (IDT) in consultation with patients to achieve quality outcomes and functional goals. On July 31, 2020, CMS issued a final rule for fiscal year (FY) 2021. Even though there are no major updates, areas impacted include Market Basket; Wage Index; PDPM Clinical Diagnosis Mappings; and the SNF Value-Based Purchasing (VBP) Program.
  • Proposed Rule for the Medicare Physician Fee Schedule: In August, CMS recommended significant payment reductions impacting therapy. As part of this Proposed Rule, therapy providers could face between a 7%-9% cut to Medicare payments, effective January 1, 2021. This proposed payment reduction will affect therapists providing services for patients in SNFs who have finished their Medicare Part A coverage and have their services covered by Medicare Part B, while either private pay or Medicaid covers room and board.

Even with all of the challenges therapy and care providers continue to face, providing quality care remains unchanged. Contact us to discuss how ATS can support your specific goals

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