CMS on Friday finalized Medicare payment rates and wage indices for skilled nursing facilities, hospices and inpatient psychiatric facilities for fiscal year 2021.
SNFs will get a $750 million pay boost in fiscal year 2021, amounting to a 2.2% increase from 2020. The rule applies a 5% cap on wage index decreases, tweaks case-mix classification code mappings used under the SNF prospective payment system and adjusts the SNF value-based purchasing program. The latter will decrease annual aggregate payments for value-based models by nearly $200 million.
CMS received a significant number of comments regarding the COVID-19 pandemic, the group and concurrent therapy limit under the Patient Driven Payment Model and other suggested changes to the PDPM case-mix classification model and quality programs under the SNF PPS, but those are outside the scope of the current rule, the agency noted.
The 2.2% hike is less than the 2.7% recommendation in the proposed rule due to slower than anticipated compensation growth amid the pandemic and economic fallout, the CMS said.
Hospice payment rates will increase by 2.4%, which translates to a $540 million bump. Facilities that do not meet quality reporting requirements will receive a 2 percentage-point reduction to their annual pay increases. Annual hospice payments will top out at $30,700. Similar to SNFs, there will also be a 5% cap on wage index decreases.
Inpatient psychiatric facilities will receive a 2.2% pay hike. CMS is also finalizing its proposal to adjust statistical area delineations to better align wage index values with actual labor costs. In addition, the final rule amends scope-of-practice laws to allow advanced practice providers to operate within states' scope-of-practice laws by documenting progress notes in medical records.