For example, for the first item, what is the reimbursement methodology for the Medicare SNF payment system? Enter N/A or none if the concept does not apply to the payment system. Submit your grid as a file attachment. Payment System Medicare Skilled Nursing Facility Services Payment System Reimbursement methodology Classification system, if applicable Packaging/bundling concepts (Are all costs for services included in the payment?) Severity of illness component (Do certain medical conditions affect classification?) Rural hospital adjustment (vs base rate) Outlier provisions Other provisions (include 2) Adjustment for wages Adjustment for cost-of-living