30 Apr 2025

🏥Proposed Payment Changes for Skilled Nursing Facilities in 2026

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026

Summary

This proposed rule would change and update policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for FY 2026. This rulemaking also proposes to update the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program.

Agencies

  • Health and Human Services Department
  • Centers for Medicare & Medicaid Services

Business Impact ?

$$$ - High

The proposed changes to the Skilled Nursing Facility (SNF) Prospective Payment System and Quality Reporting Program will directly affect payment rates and reporting requirements for SNFs, necessitating compliance from healthcare providers, which may involve operational adjustments and financial planning. Significant financial implications include an estimated increase in payments for FY 2026 and adjustments to the Value-Based Purchasing Program.

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