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.
Related insights
The Day Part A Ends, Part B Supply Billing Opens
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Read articleMedicare Part B Tracheostomy Supply Billing in a SNF: What Pays and What Doesn't
Medicare Part B pays SNFs for trach tubes, inner cannulas and daily care kits once a resident is off Part A. See the codes, the limits and what won't pay.
Read articleMedicare Quantity Limits for SNF Part B Supplies: The 3 Numbers to Check Before You Bill
Medicare limits SNF Part B supply quantities 2 ways: LCD usual maximums and MUEs. See the 3 numbers to check on every claim before it goes out.
Read articlePrimary sources
Part B rules, audit triggers, and reimbursement policy referenced on this page come from the official sources below. Coverage policy changes; confirm current requirements with CMS and your Medicare Administrative Contractor before billing.
- CMS — DMEPOS Fee Schedule
- CMS — Physician Fee Schedule
- CMS — Healthcare Common Procedure Coding System (HCPCS)
This page is general educational information, not legal, coding, or compliance advice. Burst does not guarantee reimbursement, claim approval, or any audit outcome.
Reviewed 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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