CMS released the FY 2027 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule, outlining several key updates that could impact reimbursement, reporting expectations, and future payment model adjustments. Below are key highlights.
- Payment update: Increase of 2.4% to SNF PPS rates for FY 2027 beginning October 1, 2026. This is based on the proposed 3.2% market basket and a negative 0.8% productivity adjustment.
- PDPM parity/recalibration: CMS continues to monitor PDPM parity and signals potential future adjustments; no structural overhaul proposed this cycle.
- Quality Reporting Program (QRP):
- Proposed removal of the two COVID-19 Vaccination measures.
- Proposed a shortened time frame for data submission from 4.5 months to a deadline of the 15th day of the second month after the end of the calendar quarter, which would begin with the FY 2029 SNF QRP (CY 2027 data).
- Proposed requirement of MDS data submission on “each resident receiving covered skilled care in a SNF, regardless of payer.”
- Value-Based Purchasing (VBP): Provision of estimated performance standards for FY 2029 & FY 2030 program years, as well as proposed update to snapshot dates for two measures to align with SNF QRP submission deadlines.
- Requests for Information (RFI):
- Adoption of Advanced Care Planning for the SNF QRP.
- RFI on the methodology for quantifying and addressing “case mix creep,” which points to “changes in coding or classification that do not reflect real change in patient acuity and may indicate case-mix upcoding.”
The complete proposed rule can be found here.
The Point Is: This proposed rule includes an anticipated and appreciated 2.4% increase to SNF PPS rates, while also signaling CMS’s continued focus on coding accuracy, PDPM parity, and expanded reporting expectations. CMS is also seeking input that could influence future policy decisions related to PDPM and case mix. We will continue monitoring developments and will share additional updates, including key takeaways from the final rule once released.
