Inpatient psychiatric facilities rule would increase payments 2.6%, clarify all-inclusive cost reporting

The Centers for Medicare & Medicaid Services today issued a proposed rule for the inpatient psychiatric facility prospective payment system for fiscal year 2025.

CMS proposes to increase IPF payments by a net 2.6%, equivalent to $70 million, in FY 2025. The payment update is a reflection of a 2.7% increase based on a proposed 2021-based market-basket update of 3.1% minus a productivity adjustment of 0.42 percentage points; CMS also proposes to update the outlier threshold so that estimated outlier payments remain at 2.0% of total payments, resulting in a 0.1% decrease to aggregate payments. In this rule, CMS clarifies the eligibility criteria for filing all-inclusive cost reports and makes operational changes such that, beginning Oct. 1, 2024, only government or tribally-owned IPFs can file this type of cost report. The agency also solicits comments on future revisions to PPS facility-level adjustment factors as well as the development of an IPF patient assessment instrument.

For the IPF Quality Reporting Program, CMS proposes to adopt one new quality measure on all-cause emergency department visits following IPF discharge. The agency also proposes to require IPFs to submit patient-level quality data on a quarterly basis, as opposed to the current annual requirement.

For more details, see the CMS fact sheet. CMS will accept comments on this rule through May 28.