FY 2027 Skilled Nursing Facility PPS Proposed Rule Summary

On April 7, 2026, CMS published in the Federal Register (91 FR 17678) a proposed rule updating for fiscal year (FY) 2027 the Medicare skilled nursing facility (SNF) payment rates, SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing Program (VBP). The proposed rule also includes a request for information on updating the Patient Driven Payment Model to address case-mix upcoding and improve payment accuracy. In addition, CMS seeks comments on whether it should consider using alternative data sources to construct a SNF-specific wage index for potential use in future years.

For the SNF QRP, CMS proposes to remove beginning with the FY 2028 SNF QRP the COVID-19 Vaccination Coverage Among Healthcare Personnel measure and the COVID-19 Vaccine: Percent of Patients/Residents Who are Up to Date measure. In addition, beginning with the FY 2029 SNF QRP, CMS proposes changes to the SNF QRP data submission deadlines and, beginning with the FY 2031 QRP, to require the submission of Minimum Data Set data on all residents receiving covered skilled care in a SNF. The agency also issues an REF regarding a future measure concept on advanced care planning. For the SNF VBP, CMS provides estimated numerical performance standards for the FY 2029 and 2030 program years. The agency also proposes to modify the snapshot dates used for purposes of the SNF VBP review and corrections process to align with the agency’s proposal to revise the SNF QRP’s submission deadline for MDS assessment data.

CMS estimates that the overall impact of the proposed rule will be an increase of $888 million (+2.4 percent) in Medicare payments to SNFs during FY 2027. Wage index tables are no longer published in the Federal Register. Instead, these tables are available exclusively at: Wage Index | CMS.

Comments on the proposed rule are due by June 1, 2026.