CMS Releases FY 2027 SNF Final RuleKey Updates on Reimbursement & QRP

8/11/2026 - By Cade Crawford

CMS issued the FY 2027 Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule, CMS-1843-F, on July 29, 2026. The rule updates Medicare payment policies, rates, quality reporting requirements, and value-based purchasing provisions for skilled nursing facilities. You can find key updates listed below.

Payment Updates

  • SNF PPS rates: CMS finalized a 2.4% increase for FY 2027, based on:
    • A 3.3% SNF market-basket update; less a 0.9% productivity adjustment.
  • Aggregate payments: CMS estimates the rate update will increase payments to SNFs by approximately $882.74 million.
  • SNF VBP adjustments: CMS estimates that payment reductions for certain SNFs subject to the SNF VBP net reduction will decrease FY 2027 payments by approximately $203.60 million. These reductions are not included in the SNF PPS rate-increase estimate.

SNF Quality Reporting Program

  • Measure removal: Beginning with the FY 2028 SNF QRP, CMS will remove:
    • COVID-19 Vaccination Coverage Among Healthcare Personnel; and
    • COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date.
    • Shortened data-submission timeframe: Beginning with the FY 2029 SNF QRP, CMS will reduce the data-submission timeframe from approximately 4.5 months to approximately 45 days.
    • The change is intended to reduce the lag between data submission and public reporting by up to three months.
    • SNFs will receive quality data earlier to support performance-improvement initiatives.
  • MDS data submission: CMS finalized a requirement that SNFs submit Minimum Data Set data for all residents receiving covered skilled care, regardless of payer. This aligns SNF reporting with other post-acute care settings and CMS programs.
  • Future measure development: CMS requested information on advanced care planning as a potential future SNF QRP measure topic.

SNF Value-Based Purchasing Program

  • Performance standards: CMS finalized performance standards for the FY 2029 and FY 2030 SNF VBP program years.
  • MDS-based measures: CMS updated the “snapshot date” for two MDS-based measures to align with the newly finalized SNF QRP submission deadlines, beginning with FY 2027 data.
  • Payment impact: SNFs should evaluate the potential effect of VBP performance on FY 2027 reimbursement, including possible net payment reductions.

Patient Driven Payment Model

  • Request for Information: CMS requested comments on potential updates to the Patient Driven Payment Model, including ways to address observed case-mix upcoding.
  • Future rulemaking: CMS will consider the comments received when evaluating potential payment-system changes in future rulemaking.

The SNF Prospective Payment System Final Rule can be viewed on the CMS Newsroom at: Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1843-F) | CMS. If you have questions regarding the proposed changes, contact the Saltmarsh Healthcare Consulting team.

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About the Author | Cade Crawford

Cade is a senior in the Healthcare Consulting practice at Saltmarsh. He specializes in Medicare and Medicaid cost report preparation, revenue and expenditure data analysis, and reimbursement consulting for post-acute healthcare clients.


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