Industry Insights

January Changes to SNF Part B Rates

February 2016
Author:  Julie Bilyeu

Julie Bilyeu

Managing Director


Health Care

910 E. St. Louis Street, Suite 200
P.O. Box 1190
Springfield, MO 65801-1190 (65806)


Unlike past years, skilled nursing facilities (SNF) head into a new year without facing significant changes in payments for Part B services paid under the physician fee schedule. The passing of the Medicare Access and CHIP Reauthorization Act of 2015 not only avoided a 21 percent decrease but also extended the therapy cap exceptions process.

Effective for services provided on or after January 1, 2016, SNF services paid under the Medicare physician fee schedule will be paid at a slight decrease from 2015 rates. (Rates are available for download on our website.) Your organization should immediately update billing software to reflect this change.

Providers also should note the therapy cap for 2016 has been set at $1,960 per year. As in previous years, occupational therapy has a separate cap of $1,960, while physical therapy and speech therapy share a combined $1,960 cap. In the billing period during which the cap is exceeded, all therapy services billed for that billing cycle forward must contain the modifier “KX” or risk being automatically rejected by the Medicare Administrative Contractor.

If you have any questions about how these changes could affect your organization, please contact your BKD advisor.

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