The Centers for Medicare & Medicaid Services (CMS) recently released the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and Skilled Nursing Facility (SNF) PPS rules for fiscal (FY) 2025. These proposed rules would update the prospective payment rates for both IRFs and SNFs starting on October 1, 2024.
Comments on both the IRF PPS and SNF PPS proposed rules for FY 2025 are due to CMS by close of business on May 28. CMS is expected to release the final rules for both the IRF PPS and SNF PPS later this summer.
Academy staff is currently reviewing the text of these proposed rules and analyzing their potential impact on physiatrists, and, if applicable, will draft comments for submission to CMS and distribution to membership. Members with questions about either of these proposed rules can contact Academy staff at healthpolicy@aapmr.org.
FY 2025 IRF PPS Proposed Rule
On March 27, 2024, CMS released the proposed Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) rule for FY 2025. This proposed rule would update the prospective payment rates for IRFs starting on October 1, 2024.
CMS proposes to update the IRF PPS payment rates by 2.8 percent for FY 2025. While AAPM&R appreciates that CMS recognizes the value of care that patients receive in the IRF setting, we are strongly advocating for a corresponding increase to physician payment rates. For many years, physician payment has been targeted for cuts that are unsustainable and threaten the viability of physician practices.
The proposed rule also includes four new items in the IRF-PAI as standardized patient assessment data elements related to Social Determinants of Health (SDOH). CMS is also seeking feedback with two public Requests for Information, on quality measure concepts under consideration for the future, and on a potential star rating system for publicly reporting IRF quality measures on Care Compare.
A fact sheet for this proposed rule can be found on the CMS website.
FY 2025 SNF PPS Proposed Rule
On March 28, 2024, CMS released the proposed Skilled Nursing Facility (SNF) PPS rule for FY 2025. This proposed rule would update the prospective payment rates for SNFs starting on October 1, 2024.
The proposed rule would update SNF PPS rates by 4.1 percent for FY 2025. The proposed rule would also add four new social determinants of health (SDOH) items to the SNF Quality Reporting Program (QRP), as well as revising CMS’ existing nursing home enforcement authority to improve the quality of care provided in the nation’s nursing homes.
A fact sheet for this proposed rule can be found on the CMS website.