Psychiatric PPS

Medicare beneficiaries with serious mental illnesses or alcohol- and drug-related problems may be treated in inpatient psychiatric facilities.

Medicare pays for these services through the IPF prospective payment system, which uses pre-determined rates based primarily on the patient’s condition (age, diagnosis, comorbidities) and length of stay, and the location of the IPF. Medicare also provides additional payment for IPFs that are teaching hospitals, located in Alaska and Hawaii, and/or have emergency departments.

The IPF PPS rates are intended to cover all routine, ancillary and capital costs that efficient providers are expected to incur in furnishing inpatient psychiatric care.

Related Resources

Advisory
Sign in to Download the Regulatory Advisory: Inpatient Psychiatric Facility PPS: Final Rule for FY 2021   The Centers for Medicare & Medicaid…
Advisory
Member
The Centers for Medicare & Medicaid Services April 10 issued a proposed rule for the inpatient psychiatric facility (IPF) prospective payment system for…
Advisory
Member
The Centers for Medicare & Medicaid Services (CMS) July 30 issued a final rule for the inpatient psychiatric facility (IPF) prospective payment system (PPS…
Advisory
Member
The Issue The Centers for Medicare & Medicaid Services (CMS) April 19 released draft revised guidance to clarify its ligature risk policy, which pertains…
Advisory
Member
Letter/Comment
Comments to the Centers for Medicare & Medicaid Services (CMS) on the fiscal year (FY) 2019 proposed rule for the inpatient psychiatric facilities (IPF)…