Medicare Part A PPS FY 2017 Tool Kit

Starting October 1, 2016 the new "FY2017 Rates" go into effect. You will be paid under the 66 category RUG IV system.

Please Note –The sequestration process enacted by congress is still in place and will be until congress acts on the Federal budget. The rates in this tool kit will be reduced by the sequestration amount and possibly by other actions taken by congress.

There are a variety of important changes identified in the Final Rule for FY2017, which you should study carefully. The final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNF) for fiscal year 2017. CMS projects that the final rule will increase overall payments to SNF’s by $920 million, or 2.4%, compared to 2016 levels. This tool kit focuses on the FY 2017 rates and the change in rates from FY2016 to FY2017.

Specific Instructions For Use of the PPS Tool Kit

Step 1 – Determine whether you are an “Urban” provider or a “Rural” provider, according to Medicare. To do this, look at page S-2 of your Medicare cost report. Page S-2 near the top should indicate the county you are located in, your CBSA # and whether you are designated as URBAN or RURAL. You must select the proper tool kit, either the Urban tool kit or the Rural tool kit.

Step 2 – Based on Step 1, select the version of the PPS Rate spreadsheet you want to look at:

Clicking on the links above will open the selected spreadsheet

Step 3 – CRITICAL STEP – You must select the county your SNF is located in. To do this, place your cursor on the box next to the word County and click on the drop down arrow. Now, select your county. The rates for your CBSA (your county) will then populate the spreadsheet.

Step 4 – Optional – if you want to type in your facility name and provider number there are places to do that for clean printing report. Also, if you want to input the number of days you will have in each category and estimate your total revenue, you may do that as well.

Please don’t hesitate to contact us if you have any questions.

-Axiom Healthcare Group