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TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
Skilled Nursing Facilities (SNFs)
Chapter 8
Addendum D (FY 2016)
Case-Mix Adjusted Federal Rates For Skilled Nursing Facilities (SNFs) - FY 2016
Revision:  C-1, March 10, 2017
Figure 8.D.2016-1  Case-Mix Adjusted Federal Rates For Urban SNFs By Labor And Non-Labor Component (RUG-66 Rates)
RUG-IV Category
Total rate
Labor Portion
Non-Labor Portion
Source: 80 FR 46402; Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016.
RUX
785.50
542.78
242.72
RUL
768.39
530.96
237.43
RVX
699.15
483.11
216.04
RVL
627.26
433.44
193.82
RHX
633.44
437.71
195.73
RHL
564.98
390.40
174.58
RMX
581.07
401.52
179.55
RML
533.14
368.40
164.74
RLX
510.30
352.62
157.68
RUC
595.51
411.50
184.01
RUB
595.51
411.50
184.01
RUA
497.94
344.08
153.86
RVC
510.87
353.01
157.86
RVB
442.40
305.70
136.70
RVA
440.69
304.52
136.17
RHC
445.16
307.61
137.55
RHB
400.65
276.85
123.80
RHA
352.72
243.73
108.99
RMC
391.07
270.23
120.84
RMB
367.11
253.67
113.44
RMA
302.06
208.72
93.34
RLB
380.22
262.73
117.49
RLA
244.99
169.29
75.70
ES3
717.13
495.54
221.59
ES2
561.36
387.90
173.46
ES1
501.45
346.50
154.95
HE2
484.34
334.68
149.66
HE1
402.18
277.91
124.27
HD2
453.53
313.39
140.14
HD1
378.21
261.34
116.87
HC2
427.85
295.64
132.21
HC1
357.67
247.15
110.52
HB2
422.72
292.10
130.62
HB1
354.25
244.79
109.46
LE2
439.83
303.92
135.91
LE1
367.94
254.25
113.69
LD2
422.72
292.10
130.62
LD1
354.25
244.79
109.46
LC2
371.37
256.62
114.75
LC1
313.17
216.40
96.77
LB2
352.54
243.61
108.93
LB1
299.47
206.93
92.54
CE2
391.91
270.81
121.10
CE1
361.10
249.52
111.58
CD2
371.37
256.62
114.75
CD1
340.55
235.32
105.23
CC2
325.15
224.68
100.47
CC1
301.19
208.12
93.07
CB2
301.19
208.12
93.07
CB1
278.93
192.74
86.19
CA2
254.97
176.18
78.79
CA1
237.85
164.35
73.50
BB2
270.37
186.83
83.54
BB1
258.39
178.55
79.84
BA2
224.16
154.89
69.27
BA1
213.89
147.80
66.09
PE2
361.10
249.52
111.58
PE1
343.98
237.69
106.29
PD2
340.55
235.32
105.23
PD1
323.44
223.50
99.94
PC2
292.63
202.21
90.42
PC1
278.93
192.74
86.19
PB2
248.12
171.45
76.67
PB1
237.85
164.35
73.50
PA2
205.33
141.88
63.45
PA1
196.77
135.97
60.80
Figure 8.D.2016-2  Case-Mix Adjusted Federal Rates For Rural SNFs By Labor And Non-Labor Component (RUG-66 Rates)
RUG-IV Category
Total Rate
Labor Portion
Non-Labor Portion
Source: 80 FR 46403; Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016.
RUX
803.61
555.29
248.32
RUL
787.25
543.99
243.26
RVX
706.08
487.90
218.18
RVL
637.40
440.44
196.96
RHX
632.34
436.95
195.39
RHL
566.93
391.75
175.18
RMX
574.66
397.09
177.57
RML
528.87
365.45
163.42
RLX
500.18
345.62
154.56
RUC
622.09
429.86
192.23
RUB
622.09
429.86
192.23
RUA
528.87
365.45
163.42
RVC
526.20
363.60
162.60
RVB
460.79
318.41
142.38
RVA
459.15
317.27
141.88
RHC
452.46
312.65
139.81
RHB
409.94
283.27
126.67
RHA
364.15
251.63
112.52
RMC
393.14
271.66
121.48
RMB
370.25
255.84
114.41
RMA
308.11
212.90
95.21
RLB
375.90
259.75
116.15
RLA
246.71
170.48
76.23
ES3
692.55
478.55
214.00
ES2
543.74
375.72
168.02
ES1
486.50
336.17
150.33
HE2
470.15
324.87
145.28
HE1
391.65
270.63
121.02
HD2
440.71
304.53
136.18
HD1
368.76
254.81
113.95
HC2
416.18
287.58
128.60
HC1
349.13
241.25
107.88
HB2
411.28
284.19
127.09
HB1
345.86
238.99
106.87
LE2
427.63
295.49
132.14
LE1
358.95
248.03
110.92
LD2
411.28
284.19
127.09
LD1
345.86
238.99
106.87
LC2
362.22
250.29
111.93
LC1
306.62
211.87
94.75
LB2
344.23
237.86
106.37
LB1
293.53
202.83
90.70
CE2
381.84
263.85
117.99
CE1
352.41
243.52
108.89
CD2
362.22
250.29
111.93
CD1
332.78
229.95
102.83
CC2
318.06
219.78
98.28
CC1
295.17
203.96
91.21
CB2
295.17
203.96
91.21
CB1
273.91
189.27
84.64
CA2
251.02
173.45
77.57
CA1
234.66
162.15
72.51
BB2
265.73
183.62
82.11
BB1
254.29
175.71
78.58
BA2
221.58
153.11
68.47
BA1
211.77
146.33
65.44
PE2
352.41
243.52
108.89
PE1
336.05
232.21
103.84
PD2
332.78
229.95
102.83
PD1
316.43
218.65
97.78
PC2
286.99
198.31
88.68
PC1
273.91
189.27
84.64
PB2
244.48
168.94
75.54
PB1
234.66
162.15
72.51
PA2
203.59
140.68
62.91
PA1
195.42
135.04
60.38
Figure 8.D.2016-3  Case-Mix Adjusted Federal Rates And Associated Indexes - Urban (RUG-66 Rates)
RUG-iv Category
Nursing Index
Therapy Index
Nursing Component
Therapy Component
Non-Case Mix Therapy Component
Non-Case Mix Component
Total Rate
Source: 80 FR 46398; Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016.
RUX
2.67
1.87
457.02
241.12
. . . . . . . . . .
87.36
785.50
RUL
2.57
1.87
439.91
241.12
. . . . . . . . . .
87.36
768.39
RVX
2.61
1.28
446.75
165.04
. . . . . . . . . .
87.36
699.15
RVL
2.19
1.28
374.86
165.04
. . . . . . . . . .
87.36
627.26
RHX
2.55
0.85
436.48
109.60
. . . . . . . . . .
87.36
633.44
RHL
2.15
0.85
368.02
109.60
. . . . . . . . . .
87.36
564.98
RMX
2.47
0.55
422.79
70.92
. . . . . . . . . .
87.36
581.07
RML
2.19
0.55
374.86
70.92
. . . . . . . . . .
87.36
533.14
RLX
2.26
0.28
386.84
36.10
. . . . . . . . . .
87.36
510.30
RUC
1.56
1.87
267.03
241.12
. . . . . . . . . .
87.36
595.51
RUB
1.56
1.87
267.03
241.12
. . . . . . . . . .
87.36
595.51
RUA
0.99
1.87
169.46
241.12
. . . . . . . . . .
87.36
497.94
RVC
1.51
1.28
258.47
165.04
. . . . . . . . . .
87.36
510.87
RVB
1.11
1.28
190.00
165.04
. . . . . . . . . .
87.36
442.40
RVA
1.10
1.28
188.29
165.04
. . . . . . . . . .
87.36
440.69
RHC
1.45
0.85
248.20
109.60
. . . . . . . . . .
87.36
445.16
RHB
1.19
0.85
203.69
109.60
. . . . . . . . . .
87.36
400.65
RHA
0.91
0.85
155.76
109.60
. . . . . . . . . .
87.36
352.72
RMC
1.36
0.55
232.79
70.92
. . . . . . . . . .
87.36
391.07
RMB
1.22
0.55
208.83
70.92
. . . . . . . . . .
87.36
367.11
RMA
0.84
0.55
143.78
70.92
. . . . . . . . . .
87.36
302.06
RLB
1.50
0.28
256.76
36.10
. . . . . . . . . .
87.36
380.22
RLA
0.71
0.28
121.53
36.10
. . . . . . . . . .
87.36
244.99
ES3
3.58
. . . . . . .
612.79
. . . . . . . . . .
16.98
87.36
717.13
ES2
2.67
. . . . . . .
457.02
. . . . . . . . . .
16.98
87.36
561.36
ES1
2.32
. . . . . . .
397.11
. . . . . . . . . .
16.98
87.36
501.45
HE2
2.22
. . . . . . .
380.00
. . . . . . . . . .
16.98
87.36
484.34
HE1
1.74
. . . . . . .
297.84
. . . . . . . . . .
16.98
87.36
402.18
HD2
2.04
. . . . . . .
349.19
. . . . . . . . . .
16.98
87.36
453.53
HD1
1.60
. . . . . . .
273.87
. . . . . . . . . .
16.98
87.36
378.21
HC2
1.89
. . . . . . .
323.51
. . . . . . . . . .
16.98
87.36
427.85
HC1
1.48
. . . . . . .
253.33
. . . . . . . . . .
16.98
87.36
357.67
HB2
1.86
. . . . . . .
318.38
. . . . . . . . . .
16.98
87.36
422.72
HB1
1.46
. . . . . . .
249.91
. . . . . . . . . .
16.98
87.36
354.25
LE2
1.96
. . . . . . .
335.49
. . . . . . . . . .
16.98
87.36
439.83
LE1
1.54
. . . . . . .
263.60
. . . . . . . . . .
16.98
87.36
367.94
LD2
1.86
. . . . . . .
318.38
. . . . . . . . . .
16.98
87.36
422.72
LD1
1.46
. . . . . . .
249.91
. . . . . . . . . .
16.98
87.36
354.25
LC2
1.56
. . . . . . .
267.03
. . . . . . . . . .
16.98
87.36
371.37
LC1
1.22
. . . . . . .
208.83
. . . . . . . . . .
16.98
87.36
313.17
LB2
1.45
. . . . . . .
248.20
. . . . . . . . . .
16.98
87.36
352.54
LB1
1.14
. . . . . . .
195.13
. . . . . . . . . .
16.98
87.36
299.47
CE2
1.68
. . . . . . .
287.57
. . . . . . . . . .
16.98
87.36
391.91
CE1
1.50
. . . . . . .
256.76
. . . . . . . . . .
16.98
87.36
361.10
CD2
1.56
. . . . . . .
267.03
. . . . . . . . . .
16.98
87.36
371.37
CD1
1.38
. . . . . . .
236.21
. . . . . . . . . .
16.98
87.36
340.55
CC2
1.29
. . . . . . .
220.81
. . . . . . . . . .
16.98
87.36
325.15
CC1
1.15
. . . . . . .
196.85
. . . . . . . . . .
16.98
87.36
301.19
CB2
1.15
. . . . . . .
196.85
. . . . . . . . . .
16.98
87.36
301.19
CB1
1.02
. . . . . . .
174.59
. . . . . . . . . .
16.98
87.36
278.93
CA2
0.88
. . . . . . .
150.63
. . . . . . . . . .
16.98
87.36
254.97
CA1
0.78
. . . . . . .
133.51
. . . . . . . . . .
16.98
87.36
237.85
BB2
0.97
. . . . . . .
166.03
. . . . . . . . . .
16.98
87.36
270.37
BB1
0.90
. . . . . . .
154.05
. . . . . . . . . .
16.98
87.36
258.39
BA2
0.70
. . . . . . .
119.82
. . . . . . . . . .
16.98
87.36
224.16
BA1
0.64
. . . . . . .
109.55
. . . . . . . . . .
16.98
87.36
213.89
PE2
1.50
. . . . . . .
256.76
. . . . . . . . . .
16.98
87.36
361.10
PE1
1.40
. . . . . . .
239.64
. . . . . . . . . .
16.98
87.36
343.98
PD2
1.38
. . . . . . .
236.21
. . . . . . . . . .
16.98
87.36
340.55
PD1
1.28
. . . . . . .
219.10
. . . . . . . . . .
16.98
87.36
323.44
PC2
1.10
. . . . . . .
188.29
. . . . . . . . . .
16.98
87.36
292.63
PC1
1.02
. . . . . . .
174.59
. . . . . . . . . .
16.98
87.36
278.93
PB2
0.84
. . . . . . .
143.78
. . . . . . . . . .
16.98
87.36
248.12
PB1
0.78
. . . . . . .
133.51
. . . . . . . . . .
16.98
87.36
237.85
PA2
0.59
. . . . . . .
100.99
. . . . . . . . . .
16.98
87.36
205.33
PA1
0.54
. . . . . . .
92.43
. . . . . . . . . .
16.98
87.36
196.77
Figure 8.D.2016-4  Case-Mix Adjusted Federal Rates And Associated Indexes - Rural (RUG-66 Rates)
RUG-iv Category
Nursing Index
Therapy Index
Nursing Component
Therapy Component
Non-Case Mix Therapy Component
Non-Case Mix Component
Total Rate
Source: 80 FR 46399; Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016.
RUX
2.67
1.87
436.63
278.01
. . . . . . . . . .
88.97
803.61
RUL
2.57
1.87
420.27
278.01
. . . . . . . . . .
88.97
787.25
RVX
2.61
1.28
426.81
190.30
. . . . . . . . . .
88.97
706.08
RVL
2.19
1.28
358.13
190.30
. . . . . . . . . .
88.97
637.40
RHX
2.55
0.85
417.00
126.37
. . . . . . . . . .
88.97
632.34
RHL
2.15
0.85
351.59
126.37
. . . . . . . . . .
88.97
566.93
RMX
2.47
0.55
403.92
81.77
. . . . . . . . . .
88.97
574.66
RML
2.19
0.55
358.13
81.77
. . . . . . . . . .
88.97
528.87
RLX
2.26
0.28
369.58
41.63
. . . . . . . . . .
88.97
500.18
RUC
1.56
1.87
255.11
278.01
. . . . . . . . . .
88.97
622.09
RUB
1.56
1.87
255.11
278.01
. . . . . . . . . .
88.97
622.09
RUA
0.99
1.87
161.89
278.01
. . . . . . . . . .
88.97
528.87
RVC
1.51
1.28
246.93
190.30
. . . . . . . . . .
88.97
526.20
RVB
1.11
1.28
181.52
190.30
. . . . . . . . . .
88.97
460.79
RVA
1.10
1.28
179.88
190.30
. . . . . . . . . .
88.97
459.15
RHC
1.45
0.85
237.12
126.37
. . . . . . . . . .
88.97
452.46
RHB
1.19
0.85
194.60
126.37
. . . . . . . . . .
88.97
409.94
RHA
0.91
0.85
148.81
126.37
. . . . . . . . . .
88.97
364.15
RMC
1.36
0.55
222.40
81.77
. . . . . . . . . .
88.97
393.14
RMB
1.22
0.55
199.51
81.77
. . . . . . . . . .
88.97
370.25
RMA
0.84
0.55
137.37
81.77
. . . . . . . . . .
88.97
308.11
RLB
1.50
0.28
245.30
41.63
. . . . . . . . . .
88.97
375.90
RLA
0.71
0.28
116.11
41.63
. . . . . . . . . .
88.97
246.71
ES3
3.58
. . . . . . .
585.44
. . . . . . . . . .
18.14
88.97
692.55
ES2
2.67
. . . . . . .
436.63
. . . . . . . . . .
18.14
88.97
543.74
ES1
2.32
. . . . . . .
379.39
. . . . . . . . . .
18.14
88.97
486.50
HE2
2.22
. . . . . . .
363.04
. . . . . . . . . .
18.14
88.97
470.15
HE1
1.74
. . . . . . .
284.54
. . . . . . . . . .
18.14
88.97
391.65
HD2
2.04
. . . . . . .
333.60
. . . . . . . . . .
18.14
88.97
440.71
HD1
1.60
. . . . . . .
261.65
. . . . . . . . . .
18.14
88.97
368.76
HC2
1.89
. . . . . . .
309.07
. . . . . . . . . .
18.14
88.97
416.18
HC1
1.48
. . . . . . .
242.02
. . . . . . . . . .
18.14
88.97
349.13
HB2
1.86
. . . . . . .
304.17
. . . . . . . . . .
18.14
88.97
411.28
HB1
1.46
. . . . . . .
238.75
. . . . . . . . . .
18.14
88.97
345.86
LE2
1.96
. . . . . . .
320.52
. . . . . . . . . .
18.14
88.97
427.63
LE1
1.54
. . . . . . .
251.84
. . . . . . . . . .
18.14
88.97
358.95
LD2
1.86
. . . . . . .
304.17
. . . . . . . . . .
18.14
88.97
411.28
LD1
1.46
. . . . . . .
238.75
. . . . . . . . . .
18.14
88.97
345.86
LC2
1.56
. . . . . . .
255.11
. . . . . . . . . .
18.14
88.97
362.22
LC1
1.22
. . . . . . .
199.51
. . . . . . . . . .
18.14
88.97
306.62
LB2
1.45
. . . . . . .
237.12
. . . . . . . . . .
18.14
88.97
344.23
LB1
1.14
. . . . . . .
186.42
. . . . . . . . . .
18.14
88.97
293.53
CE2
1.68
. . . . . . .
274.73
. . . . . . . . . .
18.14
88.97
381.84
CE1
1.50
. . . . . . .
245.30
. . . . . . . . . .
18.14
88.97
352.41
CD2
1.56
. . . . . . .
255.11
. . . . . . . . . .
18.14
88.97
362.22
CD1
1.38
. . . . . . .
225.67
. . . . . . . . . .
18.14
88.97
332.78
CC2
1.29
. . . . . . .
210.95
. . . . . . . . . .
18.14
88.97
318.06
CC1
1.15
. . . . . . .
188.06
. . . . . . . . . .
18.14
88.97
295.17
CB2
1.15
. . . . . . .
188.06
. . . . . . . . . .
18.14
88.97
295.17
CB1
1.02
. . . . . . .
166.80
. . . . . . . . . .
18.14
88.97
273.91
CA2
0.88
. . . . . . .
143.91
. . . . . . . . . .
18.14
88.97
251.02
CA1
0.78
. . . . . . .
127.55
. . . . . . . . . .
18.14
88.97
234.66
BB2
0.97
. . . . . . .
158.62
. . . . . . . . . .
18.14
88.97
265.73
BB1
0.90
. . . . . . .
147.18
. . . . . . . . . .
18.14
88.97
254.29
BA2
0.70
. . . . . . .
114.47
. . . . . . . . . .
18.14
88.97
221.58
BA1
0.64
. . . . . . .
104.66
. . . . . . . . . .
18.14
88.97
211.77
PE2
1.50
. . . . . . .
245.30
. . . . . . . . . .
18.14
88.97
352.41
PE1
1.40
. . . . . . .
228.94
. . . . . . . . . .
18.14
88.97
336.05
PD2
1.38
. . . . . . .
225.67
. . . . . . . . . .
18.14
88.97
332.78
PD1
1.28
. . . . . . .
209.32
. . . . . . . . . .
18.14
88.97
316.43
PC2
1.10
. . . . . . .
179.88
. . . . . . . . . .
18.14
88.97
286.99
PC1
1.02
. . . . . . .
166.80
. . . . . . . . . .
18.14
88.97
273.91
PB2
0.84
. . . . . . .
137.37
. . . . . . . . . .
18.14
88.97
244.48
PB1
0.78
. . . . . . .
127.55
. . . . . . . . . .
18.14
88.97
234.66
PA2
0.59
. . . . . . .
96.48
. . . . . . . . . .
18.14
88.97
203.59
PA1
0.54
. . . . . . .
88.31
. . . . . . . . . .
18.14
88.97
195.42
- END -
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