AHCA has developed a Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rate calculator to assist members in examining and estimating the impact of payment changes to SNF PPS rates. Using information on your distribution of Medicare Part A days by RUG category, the calculator will allow you to simulate and understand the impact of the proposed SNF PPS payment policy changes for FY 2016 on a facility.
The rate calculator has been updated to reflect Medicare payment policy changes found in the SNF PPS notice for fiscal year 2016 that was issued on May 15, 2015. The proposed rule and the rate calculator illustrate the net impact of a 2.6% increase in rates for the market basket update, a 0.6% reduction in rates due to a forecast error adjustment, and a 0.6% reduction in rates due to the Accountable Care Act (ACA) mandated productivity adjustment, for a net 1.4% increase in SNF PPS rates for FY 2014. (Please note that the individual adjustments may not add to the total adjustment due to rounding.)
To prepare the rate estimates, please take the following steps on the “Inputs and Results” tab of this Excel spreadsheet:
1. Enter your facility name.
2. Select your facility location in the drop-down menu on the line “Facility Location (CBSA)”.
3. Enter the time period that covers the Medicare patient days by RUG category for your facility.
4. Enter the Medicare patient days by RUG category under the RUG-IV payment system.
The difference between the average Medicare rate for fiscal year 2016, effective October 1, 2015, and the average Medicare rate for fiscal year 2015, effective October 1, 2014, will be expressed in dollar and percentage amounts. You will be able to estimate the impact of the per diem payment changes effective October 1, 2015. For your information, the average Medicare rate for fiscal year 2015, effective October 1, 2014 is also provided.
The information contained in the “Inputs and Results” and “Rate Calculation” tabs may be printed.
Please note that the rates provided in this calculator are the same as those published in the Federal Register. It has been determined that discrepancies may exist between the rates in this calculator and the SNF PPS PC Pricer due to rounding.