30 Apr 2025

💵Proposed Medicare Payment Updates for Inpatient Psychiatric Facilities

Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update

Summary

This rulemaking proposes to update the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPFs), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. This rulemaking also proposes to revise the payment adjustment factors for teaching status and for IPFs located in rural areas. These proposed changes would be effective for IPF discharges occurring during the fiscal year beginning October 1, 2025 through September 30, 2026. We are proposing to make changes to measures used in the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, to update and codify the Extraordinary Circumstances Exception policy, and to solicit feedback through requests for information on future changes to the IPFQR Program.

Agencies

  • Health and Human Services Department
  • Centers for Medicare & Medicaid Services

Business Impact ?

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The proposed updates to the Medicare payment rates and policies for inpatient psychiatric facilities (IPFs) have direct financial implications for business owners and executives within the healthcare sector. Increased payments and changes to quality reporting requirements may affect operational budgets and compliance strategies.

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