💵Medicare IPF Payment System Updates for FY 2026
Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update
Summary
This final rule updates 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 final rule also revises the payment adjustment factors for teaching status and for IPFs located in rural areas. These changes will be effective for IPF discharges occurring during the fiscal year beginning October 1, 2025, through September 30, 2026. We are finalizing changes to measures used in the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, updating and codifying the Extraordinary Circumstances Exception policy, and summarizing comments received through requests for information regarding future changes to the IPFQR Program.
Agencies
- Health and Human Services Department
- Centers for Medicare & Medicaid Services
Business Impact
$$$ - High
The document outlines significant regulatory changes to the Medicare payment system for inpatient psychiatric facilities, directly affecting financial outcomes for these providers. The updates to payment rates, adjustment factors, and compliance requirements will necessitate operational adjustments for affected facilities.