US · guidance
CMS Pub. 100-02, ch. 8, § 10.1
Medicare SNF PPS Overview
Section 1888(e) of the Social Security Act provides the basis for the establishment of the
per diem federal payment rates applied under the PPS to SNFs that received their first
payment from Medicare on or after October 1, 1995. A transition period applied for those
SNFs that first accepted payment under the Medicare program prior to October 1, 1995.
The Balanced Budget Act (BBA) of 1997 sets forth the formula for establishing the rates
as well as the data on which they are based. See also Pub. 15-1, Provider Reimbursement
Manual, Part I, chapter 28, section 2836 for background information on the SNF PPS;
Pub. 100-04, Medicare Claims Processing Manual, chapter 6, sections 30ff. for SNF PPS
billing instructions; and Pub. 100-08, Medicare Program Integrity Manual, chapter 6,
sections 6.1ff. regarding medical review of SNF PPS claims.
History
(Rev. 261, Issued: 10-04-19, Effective: 11-05-19, Implementation: 11-05-19)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
01561937ea44053e3a925c7897046abb7dd841eb1ae8c59d5ec12367f7d95f5e
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