CMS Issues FY 2021 Proposed Payment Rule

Carl J. Pucci in Finance & Reimbursement

CMS has issued its SNF Prospective Payment System (PPS) Proposed Rule for fiscal year 2021. 

The proposed rule incudes a net market basket increase of 2.3%, which approximates $784M nationwide. The increases, upon final approval, would be effective 10/1/20. 

Below is the AHCA announcement which contains a detailed summary of the proposed rule. 

From The Reimbursement Policy Team

CMS Issues FY 2021 SNF Proposed Payment Rule 

Dear AHCA Member:

The Centers for Medicare & Medicaid Services (CMS) today issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2021 update. 

We’re pleased to report that the proposed rule includes a net market basket increase of 2.3 percent. CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $784 million in FY 2021. 

In regard to PDPM monitoring, CMS indicates the Agency will continue to monitor the impact of PDPM implementation on patient outcomes and program outlays.  CMS notes that it would be premature to release any information related to these issues based on the amount of data currently available.” 

Finally, of note, as part of updating CBSAs, CMS is capping decreased in wage indices at 5 percent to prevent precipitous drops.  

The team at AHCA team has developed a summary of the payment updates, the SNF value-based purchasing program, and the IMPACT Act quality reporting additions. 

We appreciate your continued support, especially during this challenging time. Please do not hesitate to reach me directly with any questions or comments.  


Michael W Cheek
Senior Vice President
Reimbursement Policy


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