Coding for treatment of certain conditions has surged substantially, and as the Centers for Medicare and Medicaid Services (CMS) pulls closer to finalizing the Skilled Nursing Facility Prospective Payment System (SNF PPS) in July, the agency will be looking to see if these increases reflect legitimate changes in resident complexity and care practices rather than upcoding. With that in mind, as the comment period closes on June 3 for the proposed SNF PPS, nursing home leaders are being urged to provide real world examples to CMS, especially when it comes to potential reimbursement changes down the line tied to “case mix creep.”
Read the full article: ‘Case Mix Creep’: CMS Scrutinizes PDPM Coding Trends as SNF Providers Warned of Potential Margin Hits //
Source: https://skillednursingnews.com/2026/05/case-mix-creep-cms-scrutinizes-pdpm-coding-trends-as-snf-providers-warned-of-potential-margin-hits/