As the 2026 fiscal year settles in, skilled nursing facilities are facing a pivotal moment in reimbursement accuracy: the CMS Final Rule has finalized significant updates to PDPM ICD-10 mappings and ...

Such authority would require an act of Congress. There are several reasons why Congress should consider giving CMS the authority to retrospectively recoup the PDPM overpayment to SNFs. First, CMS’s ...

The Centers for Medicare and Medicaid Services has issued a final rule updating Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective ...

Skilled nursing facilities get a 4.1% payment increase for 2025, according to a proposed rule released by the Centers for Medicare and Medicaid Services under the Skilled Nursing Facility Prospective ...

While the April 2026 ICD-10-CM update may appear to be a routine annual refresh, it introduces significant structural shifts in coding logic that directly affect MDS 3.0 assessments and PDPM payment ...

The patient-driven payment model (PDPM) has revolutionized health care for providers and their patients. These systems heighten treatment accuracy and ensure clients receive accurate billing for their ...

On July 31, 2023, CMS issued its final rule updating the rates and Medicare payment policies under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024 (the Final Rule). The ...

After much hype, trepidation and, for some providers, feverish planning, the Patient Driven Payment Model (PDPM) took effect in October. There has been much speculation about how the new system, ...

Medicare’s Patient Driven Payment Model (PDPM) significantly altered the way skilled nursing facilities (SNFs) are paid, removing the financial incentive to maximize the volume of therapy services ...

More than a year and a half after implementing the Patient-Driven Payment Model (PDPM), how is your skilled nursing facility doing – operationally and financially? Chances are, you may still not know.