LeadingAge NY FY25 Medicare Part A Calculator Posted
(Oct. 8, 2024) Members are now able to download the Skilled Nursing Facility (SNF) Medicare Part A rate tool that LeadingAge NY compiles annually. The tool allows a user to model any combination of PDPM components, indicating both the reimbursement associated with a specific day of the stay as well as the entire stay. It contains tables showing each of the rate component adjusted by its associated set of case mix weights, lists the wage index values for all of the regions indicating which may be subject to the provision that prevents a decrease greater than 5% over the prior year, and offers an interactive calculator that can help the user better understand how PDPM is constructed and how different components impact reimbursement. The tool incorporates changes made by the Correction Notice to the final rule that was published in the Federal Register on Oct. 2, 2024.
Members using the tool should keep in mind that besides selecting the appropriate region to ensure the correct wage index is applied, it is important to use the correct tables and calculator tailored to their geography. In the SNF Prospective Payment System (PPS), the Centers for Medicare and Medicaid Services (CMS) issues two sets of base rates: one for urban areas, the other for non-urban areas.
The Microsoft Excel file is available for download here. An article outlining the payment updates and other provisions in the SNF PPS final rule are available here. Please reach out if you have questions.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841