# 2025-06348: Nursing Homes' Medicare Rates and Reports Get 2026 Refresh 2025-06348, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026, is a Federal Register proposed rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2025-04-30, effective 2025-10-01; deemed significant under Executive Order 12866; PRIA reads it as touching household money (as of 2026-10-14). - Canonical: https://policyrisk.com/federal-register/2025-06348 - As of: 2026-10-14 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Document number: 2025-06348 - Title: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026 - Type: Proposed Rule - Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services - Citation: 90 FR 18590 - Published: 2025-04-30 - Effective: 2025-10-01 - Comments close: not stated - Significant: yes (OIRA_API) - Touches household money: yes - Regulation identifier numbers: 0938-AV47 - Last updated: 2026-10-14 ## In one line Nursing Homes' Medicare Rates and Reports Get 2026 Refresh ## Summary Starting in fiscal year 2026, skilled nursing facilities (SNFs) will see updated payment rates and new rules for how Medicare pays them. The changes also tweak quality reporting and value-based programs to boost care and fairness. SNFs and Medicare users should watch for these updates, with feedback due by June 30, 2025, and potential impacts on payments and care quality. ## Abstract This proposed rule would change and update policies and payment rates used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for FY 2026. This rulemaking also proposes to update the requirements for the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program. ## Effects PRIA read - FY2026 SNF Payment Update: 2.8% Net Increase: benefit, high. For fiscal year (FY) 2026 (October 1, 2025 through September 30, 2026) the proposed SNF market-basket update net of forecast error and productivity adjustments is 2.8 percent. CMS proposes component per diem amounts for FY 2026 (examples: Urban PT $75.42, OT $70.20, Nursing $131.47; Rural PT $85.98… - SNF VBP Program Payment Reductions: cost, high. CMS estimates the SNF Value-Based Purchasing (VBP) Program changes will reduce aggregate payments to SNFs by $208.36 million in FY 2026 and by $207.99 million in FY 2027. The proposed rule also proposes estimated performance standards for FY 2028 and FY 2029 and would apply the Program's scoring me… - Removal of Four SDOH Assessment Data Elements: benefit, medium. Beginning with residents admitted on October 1, 2025 (for the FY 2027 SNF QRP), CMS proposes to remove four standardized patient assessment data elements in the social determinants of health (SDOH) category from the SNF Quality Reporting Program. CMS estimates this proposed removal would result in… - Changes to SNF QRP Reconsideration Process and Extension Cost: cost, high. CMS proposes to amend and codify the SNF Quality Reporting Program reconsideration request policy and process, and estimates that permitting an extension to file a reconsideration request will increase costs to those SNFs requesting an extension by $2,391.90 annually. - Removal of Health Equity Adjustment; New VBP Reconsideration Process: benefit, medium. CMS proposes to remove the Health Equity Adjustment from the SNF VBP Program methodology to ‘simplify the methodology and provide clearer incentives,’ and to adopt a SNF VBP program reconsideration process that would allow SNFs to appeal CMS's decisions on review and correction requests beginning w… - PDPM ICD-10 Mapping Technical Updates: benefit, low. CMS proposes technical revisions to the code mappings used to classify patients under the Patient Driven Payment Model (PDPM) to improve payment and coding accuracy. These updates are intended to change how certain diagnoses map to PDPM classifications. ## Related documents - [2026-20281](https://policyrisk.com/federal-register/2026-20281): Global Benchmark for Efficient Drug Pricing (GLOBE) Model, 2026-10-02 - [2026-20131](https://policyrisk.com/federal-register/2026-20131): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-10-01 - [2026-19959](https://policyrisk.com/federal-register/2026-19959): Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Prog…, 2026-09-30 - [2026-20067](https://policyrisk.com/federal-register/2026-20067): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction, 2026-09-30 - [2026-19946](https://policyrisk.com/federal-register/2026-19946): Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospectiv…, 2026-09-29 - [2026-15652](https://policyrisk.com/federal-register/2026-15652): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-08-03 ## Sources - [2025-06348 on federalregister.gov](https://www.federalregister.gov/documents/2025/04/30/2025-06348/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities) - [2025-06348 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06348.pdf) ## Related - [Previous: 2025-06336, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System…](https://policyrisk.com/federal-register/2025-06336) - [Next: 2025-07351, Energy Conservation Program: Notification of Petition for Rulemaking](https://policyrisk.com/federal-register/2025-07351) - [All Federal Register documents](https://policyrisk.com/federal-register) Source: PRIA, https://policyrisk.com/federal-register/2025-06348 (as of 2026-10-14).