Recently, the Centers for Medicare and Medicaid Services (CMS) issued the
final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026. AHCA has reviewed the final rule and developed a
summary outlining key provisions and impacts on members.
Please note this is for members only and requires an AHCA/NCAL log-in to view.As a reminder, the final rule:
- Increased rates by 3.2%, or approximately $1.16 billion, beginning October 1, 2025.
- Finalized several substantive changes to the PDPM ICD-10 code mappings.
- Removed four items previously adopted as standardized patient assessment data elements under the social determinants of health category beginning with the FY 2027 SNF Quality Reporting Program (QRP).
- Amended the SNF QRP and Value-Based Purchasing Program reconsideration policies and processes.
Please contact AHCA SVP of Reimbursement Policy
John Kane with questions.
SNF PPS Final Rule Webinar:AHCA will be hosting a
webinar Thursday, August 7 at 3:30 PM EST where president and CEO Clif Porter and AHCA team members will provide details on what you need to know about the payment rule.
Registration is free for AHCA/NCAL members. Questions about registration, how to join the webinar, or additional assistance request should be sent to
educate@ahca.org.