[Federal Register Volume 88, Number 191 (Wednesday, October 4, 2023)]
[Rules and Regulations]
[Pages 68486-68491]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-22050]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 411, 413, 488, and 489

[CMS-1779-CN]
RIN 0938-AV02


Medicare Program; Prospective Payment System and Consolidated 
Billing for Skilled Nursing Facilities; Updates to the Quality 
Reporting Program and Value-Based Purchasing Program for Federal Fiscal 
Year 2024; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of 
Health and Human Services (HHS).

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical errors in the final rule that 
appeared in the August 7, 2023 Federal Register, entitled ``Medicare 
Program; Prospective Payment System and Consolidated Billing for 
Skilled Nursing Facilities; Updates to the Quality Reporting Program 
and Value-Based Purchasing Program for Federal Fiscal Year 2024'' 
(referred to hereafter as the ``FY 2024 SNF final rule''). The 
effective date of the FY 2024 SNF final rule is October 1, 2023.

DATES: This document is effective October 1, 2023.

FOR FURTHER INFORMATION CONTACT: 
    John Kane, (410) 786-0557, for information related to the SNF PPS.
    Kia Burwell, (410) 786-7816, for information related to the SNF 
wage index.
    Tammy Luo, (410) 786-4325, for information related to the PDPM ICD-
10 mappings.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2023-16249 of August 7, 2023 (88 FR 53200), there were 
technical errors that are identified and corrected in this correcting 
document. These corrections are effective as if they had been included 
in the FY 2024 SNF final rule. Accordingly, the corrections are 
effective October 1, 2023.

II. Summary of Errors

A. Summary of Errors in the Preamble

    A technical error in the calculation of the final FY 2024 SNF PPS 
wage indexes required us to recalculate the wage index budget 
neutrality factor; the unadjusted SNF PPS Federal per diem rates 
provided on page 53209 in Tables 3 and 4; the case-mix adjusted SNF PPS 
rates provided on pages 53210 through 53211 in Tables 5 and 6; figures 
on pages 53214, 53215; Tables 8 and 9 on page 53215; Table 10 on pages 
53215 through 53216; a figure on page 53333; and the impact analysis 
provided on pages 53333 through 53334 in Table 30. Further discussions 
of these errors are found in section IV. of this document.
    On page 53333, we made a typographical error in a percent increase.

B. Summary of Errors and Corrections Posted on the CMS Website

1. SNF Wage Index
    As discussed in the FY 2024 SNF PPS final rule (88 FR 53211 through 
53214), in developing the wage index to be applied to SNFs under the 
SNF PPS, we use the updated, pre-reclassified, pre-rural floor hospital 
inpatient PPS (IPPS) wage data, exclusive of the occupational mix 
adjustment. For FY 2024, the updated, unadjusted, pre-reclassified, 
pre-rural floor IPPS wage data used under the SNF PPS are for cost 
reporting periods beginning on or after October 1, 2019, and before 
October 1, 2020 (FY 2020 cost report data), as discussed in the final 
rule entitled ``Medicare Program; Hospital Inpatient Prospective 
Payment Systems for Acute Care Hospitals and the Long-Term Care 
Hospital Prospective Payment System and Policy Changes and Fiscal Year 
2024 Rates; Quality Programs and Medicare Promoting Interoperability 
Program Requirements for Eligible Hospitals and Critical Access 
Hospitals; Rural Emergency Hospital and Physician-Owned Hospital 
Requirements; and Provider and Supplier Disclosure of Ownership; and 
Medicare Disproportionate Share Hospital (DSH) Payments: Counting 
Certain Days Associated with Section 1115 Demonstrations in the 
Medicaid Fraction'' (88 FR 58640) (hereinafter referred to as the FY 
2024 IPPS final rule). In calculating the wage index under the FY 2024 
IPPS final rule, we

[[Page 68487]]

made an inadvertent error related to the calculation of the wage index. 
This error is identified, discussed, and corrected in the document 
entitled ``Medicare Program; Hospital Inpatient Prospective Payment 
Systems for Acute Care Hospitals and the Long-Term Care Hospital 
Prospective Payment System and Policy Changes and Fiscal Year 2024 
Rates; Quality Programs and Medicare Promoting Interoperability Program 
Requirements for Eligible Hospitals and Critical Access Hospitals; 
Rural Emergency Hospital and Physician-Owned Hospital Requirements; and 
Provider and Supplier Disclosure of Ownership; and Medicare 
Disproportionate Share Hospital (DSH) Payments: Counting Certain Days 
Associated with Section 1115 Demonstrations in the Medicaid Fraction; 
Correction,'' published elsewhere in this issue of the Federal 
Register. The error that affects the unadjusted, pre-reclassified, pre-
rural floor IPPS wage data and thereby affects the SNF PPS wage data 
was an error in the wage data collected from the Medicare cost reports 
of one hospital (CMS Certification Number (CCN) 340064--Core-Based 
Statistical Area (CBSA) 34 rural North Carolina).
    As discussed previously in this section, we use the updated, pre-
reclassified, unadjusted IPPS wage data in developing the wage index 
used under the SNF PPS. Due to the technical errors described 
previously in this section, the published FY 2024 SNF PPS wage indexes 
were incorrect. Thus, the use of the corrected wage data for the one 
hospital in CBSA 34 required us to recalculate the final FY 2024 SNF 
PPS wage indexes. Additionally, as discussed in the FY 2024 SNF PPS 
final rule, section 1888(e)(4)(G)(ii) of the Social Security Act 
requires that we apply the wage index in a manner that does not result 
in aggregate payments under the SNF PPS that are greater or less than 
would otherwise be made if the wage index adjustment had not been made 
(88 FR 53214). To achieve this, we apply a budget neutrality factor to 
the unadjusted SNF PPS Federal per diem base rates. This revision of 
the final FY 2024 SNF PPS wage indexes requires us to recalculate wage 
index budget neutrality factor; the unadjusted SNF PPS Federal per diem 
rates provided in Tables 3 and 4 of the FY 2024 SNF PPS final rule (88 
FR 53209); the case-mix adjusted SNF PPS rates provided in Tables 5 and 
6 in the FY 2024 SNF PPS final rule (88 FR 53210 through 53211); and 
the impact analysis provided in Table 30 of the FY 2024 SNF PPS final 
rule (88 FR 53333 through 53334). The corrections to these errors are 
found in section IV. of this document.
    We are correcting the wage index in Table B setting forth the wage 
indexes for rural areas based on CBSA labor market areas (Table B), 
which is available exclusively on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html. Table B has been updated to reflect the error discussed 
in this correcting document, and we are republishing the wage indexes 
in Tables A and B accordingly on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/WageIndex.html.
2. PDPM ICD-10 Mappings
    We are correcting the following errors to the FY 2024 Patient 
Driven Payment Model (PDPM) ICD-10-CM mappings (hereinafter referred to 
as PDPM ICD-10 code mappings) that were made available on the CMS 
website at https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm in conjunction with the release of the FY 2024 SNF 
PPS final rule. The FY 2024 PDPM ICD-10 code mappings file may be 
accessed from the list of items under the ``PDPM Resources'' section of 
the website with an effective date of ``10-01-2023.'' The preamble 
language of FY 2024 SNF PPS final rule discussing ICD-10 mappings is 
unaffected by these errors.
    The first table in the FY 2024 PDPM ICD-10 code mappings file 
displays the list of ICD-10 codes that are recorded in Item I0020B ICD 
Code of the Minimum Data Set (MDS) assessment to determine a patient's 
clinical category assignment under PDPM. First, we are correcting 
errors in the clinical category assignment of 332 codes ranging from 
C00.0 through C49.6 to reinstate their prior year's assignments from 
the FY 2023 SNF PPS final rule, as we proposed no changes in clinical 
categories in this code range in the FY 2024 SNF PPS proposed rule nor 
finalized them in the FY 2024 SNF PPS final rule. Second, we are 
correcting errors in the clinical category assignments of D75.84, 
F43.81, F43.89, G90.A, and K76.82 to reflect the changes finalized in 
the FY 2024 SNF PPS final rule (88 FR 53220 through 53221).
    The second table in the FY 2024 PDPM ICD-10 code mappings file 
displays a list of ICD-10 codes associated with comorbidities included 
in the Speech-Language Pathology (SLP) component under PDPM. 
Specifically, we are removing the following new ICD-10 codes effective 
October 1, 2023, that were erroneously added, noting the addition of 
any ICD-10 code to the SLP comorbidity list would amount to a change in 
policy that would first need to undergo notice and comment rulemaking: 
G20.A1, G20.A2, G20.B1, G20.B2, G20.C, G11.6, G23.3, G31.80, G31.86, 
G37.81, G40.C01, G40.C09, G40.C11, G40.C19, G90.B, G93.42, G93.43, 
G93.44.
    Given these errors, we are republishing the PDPM ICD-10 code 
mappings accordingly on the CMS website at https://www.cms.gov/medicare/medicare-fee-for-service-payment/snfpps/pdpm effective October 
1, 2023.

III. Waiver of Proposed Rulemaking

    Under section 553(b) of the Administrative Procedure Act (the APA) 
(5 U.S.C. 553(b)), the agency is required to publish a notice of 
proposed rulemaking in the Federal Register before the provisions of a 
rule take effect. Similarly, section 1871(b)(1) of the Social Security 
Act (the Act) requires the Secretary to provide for notice of the 
proposed rule in the Federal Register and provide a period of not less 
than 60 days for public comment. In addition, section 553(d) of the APA 
and section 1871(e)(1)(B)(i) of the Act mandate a 30-day delay in 
effective date after issuance or publication of a rule. Sections 
553(b)(B) and 553(d)(3) of the APA provide for exceptions from the APA 
notice and comment, and delay in effective date requirements; in cases 
in which these exceptions apply, sections 1871(b)(2)(C) and 
1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and 60-
day comment period and delay in effective date requirements of the Act 
as well. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the 
Act authorize an agency to dispense with normal notice and comment 
rulemaking procedures for good cause if the agency makes a finding that 
the notice and comment process is impracticable, unnecessary, or 
contrary to the public interest, and includes a statement of the 
finding and the reasons for it in the rule. In addition, section 
553(d)(3) of the APA and section 1871(e)(1)(B)(ii) allow the agency to 
avoid the 30-day delay in effective date where such delay is contrary 
to the public interest and the agency includes in the rule a statement 
of the finding and the reasons for it.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects technical errors in the FY 2024 SNF final rule. The 
corrections contained in this document are consistent with, and do not 
make substantive changes to, the

[[Page 68488]]

policies and payment methodologies that were proposed, subject to 
notice and comment procedures, and adopted in the FY 2024 SNF final 
rule. As a result, the corrections made through this correcting 
document are intended to resolve inadvertent errors so that the rule 
accurately reflects the policies adopted in the final rule. Even if 
this were a rulemaking to which the notice and comment and delayed 
effective date requirements applied, we find that there is good cause 
to waive such requirements. Undertaking further notice and comment 
procedures to incorporate the corrections in this document into the FY 
2024 SNF final rule or delaying the effective date of the corrections 
would be contrary to the public interest because it is in the public 
interest to ensure that the rule accurately reflects our policies as of 
the date they take effect. Further, such procedures would be 
unnecessary because we are not making any substantive revisions to the 
final rule, but rather, we are simply correcting the Federal Register 
document to reflect the policies that we previously proposed, received 
public comment on, and subsequently finalized in the final rule. For 
these reasons, we believe there is good cause to waive the requirements 
for notice and comment and delay in effective date.

IV. Correction of Errors in the Preamble

    In FR Doc. 2023-16249 of August 7, 2023 (88 FR 53200), make the 
following corrections:
    1. On page 53209, middle of the page:
    a. TABLE 3--FY 2024 UNADJUSTED FEDERAL RATE PER DIEM--URBAN is 
corrected to read as follows:

                                                Table 3--FY 2024 Unadjusted Federal Rate Per Diem--URBAN
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Rate component                           PT               OT              SLP            Nursing            NTA          Non-case-mix
--------------------------------------------------------------------------------------------------------------------------------------------------------
Per Diem Amount...................................          $70.26           $65.40           $26.23          $122.47           $92.40          $109.68
--------------------------------------------------------------------------------------------------------------------------------------------------------

    b. TABLE 4--FY 2024 UNADJUSTED FEDERAL RATE PER DIEM--RURAL is 
corrected to read as follows:

                                                Table 4--FY 2024 Unadjusted Federal Rate Per Diem--RURAL
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Rate component                           PT               OT              SLP            Nursing            NTA          Non-case-mix
--------------------------------------------------------------------------------------------------------------------------------------------------------
Per Diem Amount...................................          $80.09           $73.56           $33.05          $117.01            88.28          $111.71
--------------------------------------------------------------------------------------------------------------------------------------------------------

    2. On page 53210, bottom of the page, TABLE 5--PDPM CASE-MIX 
ADJUSTED FEDERAL RATES AND ASSOCIATED INDEXES--URBAN (INCLUDING THE 
PARITY ADJUSTMENT RECALIBRATION) is corrected to read as follows:

               Table 5--PDPM Case-Mix Adjusted Federal Rates and Associated Indexes--URBAN (Including the Parity Adjustment Recalibration)
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                    Nursing    Nursing    Nursing
           PDPM group              PT CMI    PT rate     OT CMI    OT rate    SLP CMI    SLP rate     CMG        CMI        rate     NTA CMI    NTA rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
A..............................       1.45    $101.88       1.41     $92.21       0.64     $16.79        ES3       3.84    $470.28       3.06    $282.74
B..............................       1.61     113.12       1.54     100.72       1.72      45.12        ES2       2.90     355.16       2.39     220.84
C..............................       1.78     125.06       1.60     104.64       2.52      66.10        ES1       2.77     339.24       1.74     160.78
D..............................       1.81     127.17       1.45      94.83       1.38      36.20       HDE2       2.27     278.01       1.26     116.42
E..............................       1.34      94.15       1.33      86.98       2.21      57.97       HDE1       1.88     230.24       0.91      84.08
F..............................       1.52     106.80       1.51      98.75       2.82      73.97       HBC2       2.12     259.64       0.68      62.83
G..............................       1.58     111.01       1.55     101.37       1.93      50.62       HBC1       1.76     215.55  .........  .........
H..............................       1.10      77.29       1.09      71.29        2.7      70.82       LDE2       1.97     241.27  .........  .........
I..............................       1.07      75.18       1.12      73.25       3.34      87.61       LDE1       1.64     200.85  .........  .........
J..............................       1.34      94.15       1.37      89.60       2.83      74.23       LBC2       1.63     199.63  .........  .........
K..............................       1.44     101.17       1.46      95.48        3.5      91.81       LBC1       1.35     165.33  .........  .........
L..............................       1.03      72.37       1.05      68.67       3.98     104.40       CDE2       1.77     216.77  .........  .........
M..............................       1.20      84.31       1.23      80.44  .........  .........       CDE1       1.53     187.38  .........  .........
N..............................       1.40      98.36       1.42      92.87  .........  .........       CBC2       1.47     180.03  .........  .........
O..............................       1.47     103.28       1.47      96.14  .........  .........        CA2       1.03     126.14  .........  .........
P..............................       1.02      71.67       1.03      67.36  .........  .........       CBC1       1.27     155.54  .........  .........
Q..............................  .........  .........  .........  .........  .........  .........        CA1       0.89     109.00  .........  .........
R..............................  .........  .........  .........  .........  .........  .........       BAB2       0.98     120.02  .........  .........
S..............................  .........  .........  .........  .........  .........  .........       BAB1       0.94     115.12  .........  .........
T..............................  .........  .........  .........  .........  .........  .........       PDE2       1.48     181.26  .........  .........
U..............................  .........  .........  .........  .........  .........  .........       PDE1       1.39     170.23  .........  .........
V..............................  .........  .........  .........  .........  .........  .........       PBC2       1.15     140.84  .........  .........
W..............................  .........  .........  .........  .........  .........  .........        PA2       0.67      82.05  .........  .........
X..............................  .........  .........  .........  .........  .........  .........       PBC1       1.07     131.04  .........  .........
Y..............................  .........  .........  .........  .........  .........  .........        PA1       0.62      75.93  .........  .........
--------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 68489]]

    3. On page 53211, top of the page, TABLE 6--PDPM CASE-MIX ADJUSTED 
FEDERAL RATES AND ASSOCIATED INDEXES--RURAL (INCLUDING THE PARITY 
ADJUSTMENT RECALIBRATION) is corrected to read as follows:

               Table 6--PDPM Case-Mix Adjusted Federal Rates and Associated Indexes--RURAL (Including the Parity Adjustment Recalibration)
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                    Nursing    Nursing    Nursing
           PDPM group              PT CMI    PT rate     OT CMI    OT rate    SLP CMI    SLP rate     CMG        CMI        rate     NTA CMI    NTA rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
A..............................       1.45    $116.13       1.41    $103.72       0.64     $21.15        ES3       3.84    $449.32       3.06    $270.14
B..............................       1.61     128.94       1.54     113.28       1.72      56.85        ES2       2.90     339.33       2.39     210.99
C..............................       1.78     142.56       1.60     117.70       2.52      83.29        ES1       2.77     324.12       1.74     153.61
D..............................       1.81     144.96       1.45     106.66       1.38      45.61       HDE2       2.27     265.61       1.26     111.23
E..............................       1.34     107.32       1.33      97.83       2.21      73.04       HDE1       1.88     219.98       0.91      80.33
F..............................       1.52     121.74       1.51     111.08       2.82      93.20       HBC2       2.12     248.06       0.68      60.03
G..............................       1.58     126.54       1.55     114.02       1.93      63.79       HBC1       1.76     205.94  .........  .........
H..............................       1.10      88.10       1.09      80.18        2.7      89.24       LDE2       1.97     230.51  .........  .........
I..............................       1.07      85.70       1.12      82.39       3.34     110.39       LDE1       1.64     191.90  .........  .........
J..............................       1.34     107.32       1.37     100.78       2.83      93.53       LBC2       1.63     190.73  .........  .........
K..............................       1.44     115.33       1.46     107.40        3.5     115.68       LBC1       1.35     157.96  .........  .........
L..............................       1.03      82.49       1.05      77.24       3.98     131.54       CDE2       1.77     207.11  .........  .........
M..............................       1.20      96.11       1.23      90.48  .........  .........       CDE1       1.53     179.03  .........  .........
N..............................       1.40     112.13       1.42     104.46  .........  .........       CBC2       1.47     172.00  .........  .........
O..............................       1.47     117.73       1.47     108.13  .........  .........        CA2       1.03     120.52  .........  .........
P..............................       1.02      81.69       1.03      75.77  .........  .........       CBC1       1.27     148.60  .........  .........
Q..............................  .........  .........  .........  .........  .........  .........        CA1       0.89     104.14  .........  .........
R..............................  .........  .........  .........  .........  .........  .........       BAB2       0.98     114.67  .........  .........
S..............................  .........  .........  .........  .........  .........  .........       BAB1       0.94     109.99  .........  .........
T..............................  .........  .........  .........  .........  .........  .........       PDE2       1.48     173.17  .........  .........
U..............................  .........  .........  .........  .........  .........  .........       PDE1       1.39     162.64  .........  .........
V..............................  .........  .........  .........  .........  .........  .........       PBC2       1.15     134.56  .........  .........
W..............................  .........  .........  .........  .........  .........  .........        PA2       0.67      78.40  .........  .........
X..............................  .........  .........  .........  .........  .........  .........       PBC1       1.07     125.20  .........  .........
Y..............................  .........  .........  .........  .........  .........  .........        PA1       0.62      72.55  .........  .........
--------------------------------------------------------------------------------------------------------------------------------------------------------

    4. On page 53214, first column, first full paragraph, line 27, the 
figure ``0.9997'' is corrected to read ``0.9996''.
    5. On page 53215, above Table 8, third column, first partial 
paragraph, line 7, the figure ``$21,717.98'' is corrected to read 
``$21,715.82''.
    6. On page 53215, middle of the page, TABLE 8--PDPM CASE-MIX 
ADJUSTED RATE COMPUTATION EXAMPLE is corrected to read as follows:

                            Table 8--PDPM Case-Mix Adjusted Rate Computation Example
----------------------------------------------------------------------------------------------------------------
                                            Per diem rate calculation
-----------------------------------------------------------------------------------------------------------------
                                                                                  VPD adjustment
               Component                     Component group      Component rate      factor       VPD adj. rate
----------------------------------------------------------------------------------------------------------------
PT....................................  N                                 $98.36            1.00          $98.36
OT....................................  N                                  92.87            1.00           92.87
SLP...................................  H                                  70.82            1.00           70.82
Nursing...............................  N                                 180.03            1.00          180.03
NTA...................................  C                                 160.78            3.00          482.34
Non-Case-Mix..........................  ........................          109.68  ..............          109.68
                                       -------------------------------------------------------------------------
    Total PDPM Case-Mix Adj. Per Diem.  ........................  ..............  ..............        1,034.10
----------------------------------------------------------------------------------------------------------------

    7. On page 53215, middle of the page, TABLE 9--WAGE INDEX ADJUSTED 
RATE COMPUTATION EXAMPLE is corrected to read as follows:

[[Page 68490]]



                                                  Table 9--Wage Index Adjusted Rate Computation Example
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                         PDPM wage index adjustment calculation
---------------------------------------------------------------------------------------------------------------------------------------------------------
                                                     PDPM case-mix                                                                        Total case mix
                    HIPPS code                        adjusted per    Labor portion      Wage index       Wage index       Non-labor      and wage index
                                                          diem                                          adjusted rate       portion         adj. rate
--------------------------------------------------------------------------------------------------------------------------------------------------------
NHNC1.............................................       $1,034.10          $735.25           0.9637          $708.56          $298.85        $1,007.41
--------------------------------------------------------------------------------------------------------------------------------------------------------

    8. On pages 53215 through 53216, TABLE 10--ADJUSTED RATE 
COMPUTATION EXAMPLE is corrected to read as follows:

                                   Table 10--Adjusted Rate Computation Example
----------------------------------------------------------------------------------------------------------------
                                                                                                   Case mix and
                                                                      NTA VPD        PT/OT VPD      wage index
                           Day of stay                              adjustment      adjustment     adjusted per
                                                                      factor          factor         diem rate
----------------------------------------------------------------------------------------------------------------
1...............................................................             3.0             1.0       $1,007.41
2...............................................................             3.0             1.0        1,007.41
3...............................................................             3.0             1.0        1,007.41
4...............................................................             1.0             1.0          694.15
5...............................................................             1.0             1.0          694.15
6...............................................................             1.0             1.0          694.15
7...............................................................             1.0             1.0          694.15
8...............................................................             1.0             1.0          694.15
9...............................................................             1.0             1.0          694.15
10..............................................................             1.0             1.0          694.15
11..............................................................             1.0             1.0          694.15
12..............................................................             1.0             1.0          694.15
13..............................................................             1.0             1.0          694.15
14..............................................................             1.0             1.0          694.15
15..............................................................             1.0             1.0          694.15
16..............................................................             1.0             1.0          694.15
17..............................................................             1.0             1.0          694.15
18..............................................................             1.0             1.0          694.15
19..............................................................             1.0             1.0          694.15
20..............................................................             1.0             1.0          694.15
21..............................................................             1.0            0.98          690.42
22..............................................................             1.0            0.98          690.42
23..............................................................             1.0            0.98          690.42
24..............................................................             1.0            0.98          690.42
25..............................................................             1.0            0.98          690.42
26..............................................................             1.0            0.98          690.42
27..............................................................             1.0            0.98          690.42
28..............................................................             1.0            0.96          686.70
29..............................................................             1.0            0.96          686.70
30..............................................................             1.0            0.96          686.70
                                                                 -----------------------------------------------
    Total Payment...............................................  ..............  ..............       21,715.82
----------------------------------------------------------------------------------------------------------------

    9. On page 53333, third column, fourth full paragraph, line 6, the 
figure ``3.0'' is corrected to read ``3.3''.
    10. On pages 53333 through 53334, TABLE 30--IMPACT TO THE SNF PPS 
FOR FY 2024 is corrected to read as follows:

                                   Table 30--Impact to the SNF PPS for FY 2024
----------------------------------------------------------------------------------------------------------------
                                                                      Parity
                                                     Number of      adjustment      Update wage    Total change
                Impact categories                   facilities     recalibration     data (%)           (%)
                                                                        (%)
----------------------------------------------------------------------------------------------------------------
                                                      Group
----------------------------------------------------------------------------------------------------------------
Total...........................................          15,503            -2.3             0.0             4.0
Urban...........................................          11,254            -2.3             0.1             4.1
Rural...........................................           4,249            -2.2            -0.7             3.3
Hospital-based urban............................             366            -2.3             0.0             4.0
Freestanding urban..............................          10,888            -2.3             0.1             4.1
Hospital-based rural............................             378            -2.2            -0.3             3.7

[[Page 68491]]

 
Freestanding rural..............................           3,871            -2.2            -0.7             3.3
----------------------------------------------------------------------------------------------------------------
                                                 Urban by region
----------------------------------------------------------------------------------------------------------------
New England.....................................             734            -2.3            -0.7             3.2
Middle Atlantic.................................           1,471            -2.4             1.3             5.3
South Atlantic..................................           1,945            -2.3             0.1             4.1
East North Central..............................           2,181            -2.3            -0.7             3.2
East South Central..............................             555            -2.2             0.0             4.0
West North Central..............................             958            -2.3            -0.4             3.6
West South Central..............................           1,454            -2.3             0.0             4.0
Mountain........................................             546            -2.3            -0.9             3.0
Pacific.........................................           1,404            -2.4             0.1             4.0
Outlying........................................               6            -2.0            -2.6             1.6
----------------------------------------------------------------------------------------------------------------
                                                 Rural by region
----------------------------------------------------------------------------------------------------------------
New England.....................................             117            -2.3            -1.1             2.8
Middle Atlantic.................................             205            -2.2            -0.3             3.7
South Atlantic..................................             489            -2.2             0.1             4.2
East North Central..............................             907            -2.2            -0.9             3.1
East South Central..............................             491            -2.2            -0.8             3.2
West North Central..............................           1,011            -2.2            -0.9             3.1
West South Central..............................             738            -2.2            -0.5             3.5
Mountain........................................             199            -2.3            -0.7             3.3
Pacific.........................................              91            -2.3            -2.0             1.9
Outlying........................................               1            -2.3             0.1             3.9
----------------------------------------------------------------------------------------------------------------
                                                    Ownership
----------------------------------------------------------------------------------------------------------------
For profit......................................          10,912            -2.3             0.0             4.0
Non-profit......................................           3,573            -2.3             0.0             3.9
Government......................................           1,018            -2.3            -0.4             3.6
----------------------------------------------------------------------------------------------------------------
Note: The Total column includes the FY 2024 6.4 percent market basket update. The values presented in Table 30
  may not sum due to rounding.


Wilma Robinson,
Deputy Executive Secretary, Department of Health and Human Services.
[FR Doc. 2023-22050 Filed 9-29-23; 4:15 pm]
BILLING CODE 4120-01-P