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Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update
Plain English Summary
The Medicare program is planning to update payment rates for inpatient psychiatric facilities, which include psychiatric hospitals and certain units within general hospitals. These changes will affect services provided from October 1, 2026, to September 30, 2027. Additionally, there will be a new patient assessment tool introduced, and two existing quality measures will be removed. Agents should prepare for these updates and inform their clients about the changes in payment rates and assessment processes.
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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 refinement of the IPF PPS outlier policy. These changes would be effective for IPF discharges occurring during the fiscal year beginning October 1, 2026, through September 30, 2027. We are also proposing the implementation of a standardized IPF patient assessment instrument, and the removal of two measures used in the Inpatient Psychiatric Facilities Quality Reporting Program.