Creator: Patrick Connole
CMS’s Final Doc Payment Rule Keeps Win for SNF Physicians
CMS has kept language in its final Medicare physician payment rule to benefit clinicians in the SNF setting.
CMS this week issued a rule that finalizes policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after Jan. 1, 2027, maintaining a provision to equalize payment for nursing facility visits regardless of a patient’s Part A status.
This makes final the draft rule’s language on the matter that was issued in July. After the draft came out, stakeholders called the change a big win for residents in skilled nursing care and the physicians who care for them.
At issue was a well-intentioned change last year when Medicare gave doctors visiting Part B (long-stay) SNF patients a 4 percent payment increase. At the same time, Medicare cut payments 7 percent for doctor visits to short-stay SNF residents (Part A). In the final rule, CMS said the payments would be the same and at the higher rate.
The exact section in the final rule is as below:
Response to Comments: Commenters were unanimously supportive of our proposal to set the facility PE RVU equal to the non-facility PE RVU for nursing facility E/M codes (CPT codes 99304 through 99310, 99315 and 99316).
Final Policy: After consideration of public comments, we are finalizing to set the facility PE RVU equal to the non-facility PE RVU for nursing facility E/M codes (CPT codes 99304 through 99310, 99315 and 99316), as proposed.
Read the final rule at 2026-22743.pdf.
Read two Park Place articles on the payment equalization language at
SNF Sector Digests Physician Payment Rule, Gives Initial Takes | Park Place and
Big Win for SNF Care; CMS Seeks ‘Equalized’ Payment in New Rule | Park Place.
Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.
