Summary of FY26 SNF Proposed Payment Rule (SNF)

On April 11, the Centers for Medicare and Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility prospective payment system (PPS) fiscal year 2026 update. AHCA reviewed and summarized the proposed rule, outlining key provisions and impacts on members. You will need your AHCA/NCAL login to access the summary.​ Click here if you have not yet set one up.

The proposed rule:

• ​Would increase SNF PPS rates by 2.8%, or approximately $997 million, beginning October 1, 2025. This is based on the proposed SNF market basket increase of 3.0%, plus a 0.6% market basket forecast error adjustment and a negative 0.8% productivity adjustment.
• Includes updates to PDPM ICD-10 code mappings and the SNF Quality Reporting Program. There were no proposed changes to the SNF Value-Based Purchasing Program for FY26, but future year changes are proposed for comment.
• Includes a request for information (RFI) for streamlining regulations and reducing administrative burdens. In every Medicare payment rule issued last week, CMS announced this RFI to comply with President Trump’s Executive Order “Unleashing Prosperity Through Deregulation.”