SNF Providers Will See an Increase in Part B Payments for July Services
Author: Julie Bilyeu
Skilled nursing facility (SNF) providers that get a significant amount of reimbursement under the Medicare Physician Fee Schedule (MPFS) have received a much-needed reprieve.
The MPFS reimbursement outlook for 2015 was initially gloomy, as providers faced the possibility of a 21 percent payment reduction and the expiration of therapy cap exceptions—both of which were set to occur on April 1, 2015. For SNF providers with a high volume of Part B therapy services paid under the MPFS, these changes could have had a significant impact on their bottom line.
Fortunately on April 16, 2015, the recently signed Medicare Access and CHIP Reauthorization Act of 2015 creates some positive changes for those services paid under the MPFS.
Here’s a closer look at the changes affecting SNF Part B services:
- Part B rates that would have expired March 31, 2015, were extended through June 30, 2015.
- The Part B therapy cap exception process was extended through December 31, 2017.
- Part B rates were increased by 0.5 percent, effective with service dates of July 1, 2015, through December 31, 2015.
- Part B rates will increase annually by 0.5 percent for calendar years 2016 through 2019.
- Changes to new Part B payment models were outlined beginning in 2019.
- The system is moving from mandatory Part B therapy review (for claims exceeding the $3,700 threshold) to review based on facilities with outliers.
Prior to submitting Medicare Part B claims for July service dates, SNF providers will need to update existing rates in their billing software systems. The Part B rates effective with July 2015 service dates can be downloaded for free from BKD’s website.
If you have any questions about how these changes could affect your organization, please contact your BKD advisor.