August 3, 2023
Payment rate and quality measure updates were the primary policies included in the final payment rules for inpatient rehabilitation [PDF] and skilled nursing facilities [PDF] (IRFs and SNFs, respectively) issued recently by the Centers for Medicare & Medicaid Services (CMS). The policies of these rules will go into effect on October 1, 2023.
CMS estimates that overall IRF payments for fiscal year (FY) 2024 will increase by 4.0% (or $355 million) relative to payments in FY 2023.
CMS will add the following measures to the IRF QRP in future program years:
The following measures will be removed from the IRF QRP beginning with the FY 2025 program year:
Payment rates for SNF services will increase by approximately 4.0% in FY 2024; an increase in spending of approximately $1.4 billion from FY 2023. This is reflective of a market basket increase of nearly 6.5% less the 2.3% patient driven payment model (PDPM) parity adjustment. The parity adjustment was phased in over two years (FYs 2023 and 2024) to offset higher than expected Medicare spending during the transition to PDPM. With this transition, therapy delivery fell dramatically while spending continued to increase. ASHA remains committed to working with CMS to ensure speech-language pathology services continue to be an integral part of service delivery in SNFs and patient quality and outcomes are maintained.
In a response [PDF] to a request for information included in the proposed rule released earlier this year, ASHA recommended CMS update the speech-language pathology International Classification of Diseases (ICD) 10 code mappings to include codes J00-J06 associated with respiratory conditions. CMS responded stating that it would consider the inclusion of these codes in future rulemaking.
CMS will add the following measures to the SNF QRP in future years:
CMS will remove the following measures beginning in FY 2025:
The following measures will be added to the VBP in future years:
Beginning with the FY 2027 program year, a health equity scoring adjustment will be adopted to reward facilities that perform well and serve a population where at least 20% of patients are dually eligible for Medicare and Medicaid.
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