Medicare Program: Prospective Payment System & Consolidated Billing for Skilled Nursing Facilities for FY 2012

August 8, 2011 The prospective payment system (PPS) for skilled nursing facilities (SNFs) provides a per diem rate for Medicare Part A services, which include covered routine and ancillary care of inpatient SNF services. The per-diem rates have four components: nursing case-mix, therapy case-mix, therapy non-case-mix, and non- case mix. For fiscal year 2012, Medicare recalibrated the case mix index, and clarified circumstances when SNFs must report breaks of three or more days of therapy, and introduced streamlined procedures for documenting situations that involve a brief interruption in therapy. Download the Report . . .