Fiscal Year (FY) 2022 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (CMS-1746-F) was released on July 29, 2021 by the Center for Medicare and Medicaid Services (CMS). Here is what you need to know about the Final Rule for Skilled Nursing Facilities.

Thanks to the stakeholder comments received by the CMS they will not start a recalibrated parity adjustment in FY 2022 to compensate for the unintended 5% increase in payment in FY 2020. However, SNFs will receive slightly less in payments than anticipated in the proposed rule for FY 2022. CMS now anticipates 1.2 percent increase in the payment rate instead of the 1.3 percent increase estimated in the proposal. See the tables below for the final FY 2022 rates.

Federal Patient Driven Payment Model (PDPM) Rate FY 2022

The following are FY 2022 Unadjusted Federal Rate Per Diem and PDPM Case-Mix Adjusted Federal Rates and Associated Indexes showing data for both Urban and Rural areas.

Table 4: FY 2022 Unadjusted Federal Rate Per Diem, Urban

Table 5: FY 2022 Unadjusted Federal Rate Per Diem, Rural

Table 6: PDPM Case-Mix Adjusted Federal Rates and Associated Indexes, Urban

Table 7: PDPM Case-Mix Adjusted Federal Rates and Associated Indexes, Rural

The Final Rule also Includes:

• CMS adoption of the SNF Healthcare Associated Infection (HAI) and the Vaccine Coverage Among Healthcare Personnel Quality Reporting Program (QRP) measures.
• Section 134 of the Consolidated Appropriations Act, 2021 – New Blood Clotting Factor Exclusion from SNF Consolidated Billing
• VBP special scoring policies due to the COVID-19 Public Health Emergency (PHE)

Helpful Resources

The updated Wage Index with the Final FY 2022 Rule: Updated Wage Index FY 2022

The PDPM ICD-10 mapping tool was updated will all the proposed revisions: PDPM ICD10 Mapping FY 2022

Skilled Nursing Facilities Final Rule for FY 2022

Skilled Nursing Facilities Fact Sheet

Contact Us

Want to know what your reimbursement would look like with the 2022 FY rates? Contact your local Blue & Co. Advisor or a member of our Post Acute Care team, and we can assist you with projections and help you identify areas of missed opportunities.

Landon Hackett, Director
317.713.7929

Stephanie Fey, Manager
502.992.2582