CMS Issues FY 2020 SNF PPS Final Rule

Carl J. Pucci in Finance & Reimbursement

CMS has issued the FY 2020 Final Rule effective 10/1/19, which updates the Medicare Prospective Payment System, as well as quality reporting requirements for SNFs. Highlights of the Final Rule include the following: 

  • Market basket increase of 2.4% (additional $851 million nationwide) 
  • Implementation of the Patient-Driven Payment Model (PDPM) which replaces RUGS IV 
  • Modifications to the SNF Quality Reporting Program (QRP) and to the SNF Value Based Program (VBP)

The attached cover letter from AHCA includes links to the Final Rule, a summary analysis and the final Case Mix Group Rates. In addition, registration links for the virtual PDPM and ICD-10 training resources are provided. 

AHCA is developing a PDPM rate tool, expected later this month. The tool will be accompanied with a respective user manual, as well as a related instructional webinar. Once released, this tool should enable finance staff to project PDPM revenue and confirm related payment remittances. 

NYSHFA will alert members and post the rate tool as soon as it becomes available.


Carl J. Pucci
Chief Financial Officer
518-462-4800 x36