Inpatient Psych Facilities Prospective Payment System FY 2021 Proposed Rule Released

Posted on April 16, 2020

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to update the inpatient psychiatric facilities (IPF) prospective payment system (PPS) for fiscal year (FY) 2021, which begins Oct. 1. Highlights of the proposed rule include:

  • A net 2.4% payment increase, comprised of a 3% marketbasket update, offset by a statutorily required 0.4 percentage point productivity reduction and a budget-neutrality adjustment.
  • An increase to the IPF PPS federal per diem base rate to $817.59 from $798.55. Providers that fail to report quality data would have their per diem base rate set at $801.65.
  • An increase in the electroconvulsive therapy payment per treatment to $351.99 from the current $343.79.  Providers that fail to report their quality data would have their payment set at $345.13.
  • An increase in the labor-related share of the rate to 77.2% from the current 76.9%, which will increase payments to facilities with an area wage index greater than 1.0.
  • A 10% increase in the fixed-dollar loss threshold from $14,960 to $16,520.
  • A 5% stop-loss provision for all IPF providers that are negatively impacted by their wage index.
  • No changes to the IPF quality reporting program.

The CMS will accept comments on the proposed rule through June 9. In the next few weeks, the MHA will provide members with a detailed summary of the proposed rule and facility-specific impact analyses. The MHA will release its draft comments prior to the due date to further assist members in commenting on the rule. Members with questions should contact Vickie Kunz at the MHA.

Tags: CMS, IPF, PPS, Vickie Kunz

Posted in: Member News

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