Therapy Management & Consulting Services Blog

CMS Publishes SNF PPS Final Rule for FY 2014

On August 1,
2013 CMS published the final rule for the Prospective Payment System and
Consolidated Billing for Skilled Nursing Facilities for FY 2014 which will be
effective October 1, 2013 for FY 2014.

  • Updated Payment Rates: Net rate increase of 1.3% or $500
    million

            2.3% Update factor

           -0.5 Market basket forecast error or adjustment

           -0.5% Multifactor productivity (MFP) adjustment per ACA 2010

            Budget neutrality factor changes to 1.006

  • Monitoring of FY2012 policy changes

           Individual therapy delivered 99.5% of time per MDS 3.0 data

           Ultra High Category utilization did not significantly change

           11% of MDS submissions are COT OMRA assessments

  • Wage Index Adjustment

          Addition of a few new Core Based Statistical Areas (CBSA)

          Shift of some urban areas to rural and rural to urban

          Some CBSAs have been split

  • Rate Calculation

         Rebasing: Shifting base year from FY 2004 to FY 2010

  • Additional MDS items

         Adding item 004200, Distinct Calendar Days of Therapy to MDS assessment form sets  
         and to the RUG-IV grouper to align MDS and RUG process with existing coverage and 
         level of care requirements (5 days of skilled therapy service)

Tags: skilled nursing facility