Medicare Fee Schedule for SNFs
Last updated May 2026
How fee schedules are structured
DMEPOS items are paid based on the DMEPOS Fee Schedule (updated quarterly). Drugs are paid at ASP + 6% under Part B. Supplies are paid at the lower of charge or fee schedule. Geographic adjustments apply by MAC region.
Why it matters
Without knowing the fee schedule, it's impossible to estimate recoverable revenue, model contingency economics, or evaluate whether a billing partner is leaving allowable amounts on the table.
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Frequently asked questions
- Rates derive from the published Medicare fee schedules applicable to the item and locality. Actual payment varies by jurisdiction, adjustment factors, and beneficiary cost-sharing, so treat published amounts as a planning reference.
- At minimum annually when CMS publishes updates, and again when your MAC issues a mid-year change. We re-verify quarterly as part of our own review cycle.
- No. Medicare typically pays 80 percent of the allowed amount, with the balance falling to a secondary payer or the beneficiary, subject to deductible status.
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Read articleReviewed by Eric Hansen, Chief Executive Officer & Founder · August 2026. Rate references are planning figures drawn from published fee schedules and vary by jurisdiction.
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