Inpatient Psychiatric Facilities FY 2020 Prospect Payment System Final Rule Released

Posted on August 07, 2019

The Centers for Medicare & Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service prospective payment system (PPS) for inpatient psychiatric facilities (IPFs) for fiscal year (FY) 2020. Highlights include:

  • A net 2.0% increase in the per diem base rate from the current $782.78 to $798.55 for facilities that comply with the CMS quality data reporting requirements. In addition, the payment per treatment for electroconvulsive therapy services will increase 2% from $337 to $343.79.
  • Revising the marketbasket to use 2016 data as the base year instead of 2012 data, which has been used since the inception of the IPF PPS.
  • A change to use the concurrent inpatient hospital PPS wage index data for IPFs starting in FY 2020, instead of using the prior year hospital wage index.
  • An increase in the labor-related share of the rate from 74.8% to 76.9%.
  • A 16.3% increase in the outlier threshold from $12,865 to $14,960 to maintain estimated outlier payments at 2% of total estimated aggregate IPF PPS payments.
  • Adoption of the new Medication Continuation Following Inpatient Psychiatric Discharge (National Quality Form #3205) claims-based measure in the IPF quality reporting program (QRP). This measure will track whether patients admitted with diagnoses of major depressive disorder, schizophrenia or bipolar disorder fill at least one prescription for an evidence-based medication to use after discharge. Discharges in the performance period July 1, 2017, through June 30, 2019, will be used for the FY 2021 payment determination. The addition of this measure results in 14 total measures in the IPF QRP.

In the coming weeks, the MHA will provide additional detail of the final rule, including updated facility-specific impact analyses. Members with questions should contact Vickie Kunz at the MHA.

Tags: Medicare, IPF, PPS, final rule, inpatient psychiatric facilities

Posted in: Member News

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