Industry Updates

July 31, 2026

SNF Final Rule Overview: CMS Finalizes 2.4% Payment Update for FY 2027

The FY 2027 SNF PPS Final Rule contains several items that will be important for providers.

Key Takeaways

CMS finalized a 2.4% net payment increase for FY 2027. The    update is based on:

• 3.3% SNF Market Basket Increase
• Minus 0.9% Productivity Adjustment

CMS did not finalize significant changes to PDPM reimbursement methodology. Only technical ICD-10 coding updates were adopted. This provides reimbursement stability for FY 2027. 

CMS expressed ongoing concern regarding increases in coding intensity since PDPM implementation, particularly in areas such as:

• Malnutrition
• Swallowing disorders
• Depression

No payment adjustment was finalized this year, but CMS requested stakeholder feedback and may propose future adjustments in FY 2028 or later.

Beginning with FY 2028 SNF Quality Reporting Program requirements, CMS finalized removal of:

• COVID-19 Vaccination Coverage Among Healthcare Personnel
• COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date

This aligns with what we discussed earlier regarding COVID vaccination quality reporting requirements ending within the SNF QRP framework.

CMS finalized shortening the QRP submission window from approximately 4.5 months to about 45 days, beginning with the FY 2029 SNF QRP.

To read the full article from Jodi Eyigor go to the link below:

 SNF Final Rule Overview: CMS Finalizes 2.4% Payment Update for FY 2027 

August 2026 -Tell CMS to Keep OT Payment Gains and Address Concerns in 2027 Medicare Part B Proposal 

This document encourages OT practitioners to submit comments to CMS on proposed Medicare Physician Fee Schedule (PFS) changes that could affect OT reimbursement, service delivery, and future practice opportunities.

• CMS is proposing changes to its Practice Expense methodology, including eliminating the Indirect Practice Cost Index (IPCI).
• AOTA believes this change would significantly improve OT valuation and reimbursement under Medicare Part B.
• Practitioners are encouraged to explain how years of payment reductions have affected patient access, staffing, technology investments, and service availability.

• CMS is evaluating whether caregiver training should remain a separately billable Medicare service.
• OT practitioners are encouraged to support continued recognition and reimbursement of caregiver training.
• Comments should also address current billing barriers that make caregiver training difficult to provide and bill in real-world practice.

• CMS is proposing payment for new health and wellness coaching services focused on behavior change, goal setting, and chronic disease self-management.
• OT practitioners are not currently recognized as qualified providers unless they obtain additional coaching certifications.
• CMS is seeking feedback, and OTs are encouraged to advocate for recognition based on their existing education, licensure, and expertise in health promotion and behavior change.

• CMS is proposing new RTM restrictions, including limiting services to established patients and changing staffing requirements.
• Practitioners should share how RTM supports patient engagement, adherence, monitoring, and clinical decision-making.
• Comments should address how proposed restrictions could impact workflows, staffing models, and beneficiary access to OT services.

CMS is actively seeking stakeholder feedback. OT practitioners are encouraged to provide personal, real-world examples showing how these policy proposals affect patient care, access to services, and the ability of OT professionals to deliver high-quality, effective interventions.

To read the full article from AOTA go to the link below:

 Legislative Action Center