Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update
AI-generated summary for informational purposes only. Not legal advice. See the original source for the authoritative text.
This proposed rule aims to update the payment rates, outlier thresholds, and wage indices for Medicare inpatient services in psychiatric facilities for the fiscal year 2027. It introduces a cap on outlier payments and proposes to implement a standardized patient assessment instrument while removing two previously utilized quality measures. This rule is intended to improve payment accuracy and ensure effective psychiatric care provision under Medicare.
AI-generated summary. May contain errors. Refer to official sources for legal decisions.
Key Changes
- Update of the IPF PPS Federal per diem base rate from $892.87 to $912.58.
- Implementation of a cap on outlier payments to 20% of the total payments.
- Removal of two quality measures from the IPF Quality Reporting Program.
Obligations
What this law requires
Submit comments on the proposed rule by June 1, 2026 through one of three methods: electronically via https://www.regulations.gov/docket/CMS-2026-1123, by regular mail to CMS-1847-P at P.O. Box 8010, Baltimore, MD 21244-8010, or by express/overnight mail to CMS-1847-P at Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850
Implement updated IPF PPS Federal per diem base rate of $912.58 (previously $892.87) for Medicare inpatient services effective for discharges occurring October 1, 2026 through September 30, 2027
Implement updated electroconvulsive therapy (ECT) payment per treatment of $688.73 (previously $673.85) effective for FY 2027 discharges
Cap outlier payments to no more than 20 percent of total IPF PPS payments in a year, with fixed dollar loss threshold adjusted to $37,820 (previously $39,360)
Implement a standardized IPF patient assessment instrument (IPF-PAI) as mandated by section 4125(b)(1) of the Consolidated Appropriations Act of 2023