CMS has released the FY 2027 SNF PPS Final Rule, effective October 1, 2026. While the SNF Prospective The 2027 Proposed Fee Schedule impacting our long-term care Part B reimbursement, effective January 1, 2027, has been released with an expected finalization later this fall. ADVION, our advocacy group as well as the therapy association groups are providing response letters to CMS during this open period.
Highlights we are following that most directly impact our skilled nursing sector include the below items:
- Anticipated overall 1.5% increase in most frequently utilized CPT Codes by therapists in the SNF setting
- The Fee Schedule is calculated with a robust formula accounting for CMS’ adjustments for Labor, Practice Expense, Malpractice Insurance, Geographic Practice Costs, a Relative Value Unit and Conversion Factor
- 10 new speech codes replacing the current frequently used SLP CPT Code of 92507
- Please note the following:
- These new codes will be specific to the disorder being addressed as well as time spent
- MPPR reduction will apply to the base codes (30 minutes) but NOT the add on codes (additional 15 minutes)
*potential oversight – these new codes were not included on the Telehealth list - ASHA (American Speech and Hearing Association) and ADVION will be hosting an educational webinar in November (once finalized)
- Software updates will be required for therapy documentation systems as well as providers billing systems prior to January 1, 2027
- Please note the following:
- KX Modifier 2.5% increase to the threshold > from $2,480 to $2,540 for PT and ST combined and OT
For additional information, check out CMS’ fact sheet.
The Point Is: Therapists and billing department updates are the norm each year by January 1, however, this Speech Code change is a significant change for clinicians and billers. We will continue to provide details once the Fee Schedule is finalized.
