The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) prospective payment system (PPS) for inpatient psychiatric facilities (IPF) for fiscal year (FY) 2024, which begins Oct. 1, 2023.
Key provisions of the final rule include:
- A 3.5% net increase to the IPF federal per diem base rate for providers that comply with the CMS IPF quality reporting (QR) program requirements, resulting in a final rate of $895.63, an increase from the current rate of $865.63.
- A 3.5% increase to the electroconvulsive therapy per diem payment rate from the current $372.67 to $385.58 for providers that comply with the CMS IPF QR program requirements.
- A rebased IPF PPS market basket to use FY 2021 data instead of FY 2016.
- An increase in the labor-related share from the current 77.4% to 78.7%.
- A 36% increase in the outlier threshold amount from the current $24,630 to $33,470 to maintain estimated outlier payments at 2% of total estimated aggregate IPF PPS payments. This will result in fewer cases qualifying for an outlier payment.
- Modifying the excluded unit regulation to allow a hospital to open a new IPF unit and begin being paid under the IPF PPS at any time during the cost reporting period if the hospital meets certain requirements. Currently facilities cannot attain excluded unit status in the middle of a cost reporting period.
- Changes to the IPF QRP including:
- Adopting new quality measures, including one on patient experience.
- Modifying the COVID-19 Vaccination Coverage Among Health Care Personnel measure
- Removing two measures:
- Patients Discharged on Multiple Antipsychotic Medications with Appropriate Justification (HBIPS-5).
- Tobacco Use Brief Intervention Provided or Offered and Tobacco Use Brief Intervention Provided (TOB-2/2a).
- Adopting a data validation pilot program starting with data submitted in 2025.
The MHA will provide IPFs with a facility-specific impact analysis and additional details on the final rule in the near future.
Members with questions should contact Vickie Kunz at the MHA.