On March 28, 2024, CMS issued its fiscal year (FY) 2025 prospective payment system (PPS) proposed payment rule for inpatient psychiatric hospitals (IPFs). The proposed rule is expected to be published in the Federal Register on April 3, 2024, and comments are due by 5 pm ET on May 28, 2024.
CMS proposed the following changes to FY 2025 payment rates. First, CMS proposed an increase of 2.7 percent to the IPF PPS payment rate. CMS also proposed to update the outlier threshold in order for outlier payments to stay at 2.0 percent of total payments, which CMS believes will decrease aggregate payments by 0.1 percent. Accordingly, as compared with FY 2024 payments, CMS calculates that FY 2025 payments to IPFs would increase by $70 million, which would reflect a 2.6 percent increase. The agency also proposes changes to the IPF patient-level adjustment factors as well. Additionally, the proposed rule would increase the per-treatment amount of electroconvulsive therapy treatments from $385.58 to $660.30.
CMS also proposes the following:
- Clarifications to the eligibility criteria to elect to file an all-inclusive cost report; and
- Changes to ensure that only government-owned or tribally-owned IPF hospitals may file an all-inclusive cost report.
CMS solicits comments on the burden that additional data collection under the Consolidated Appropriations Act of 2023 will impose and ways the agency can minimize the burden as well as feedback on IPF FFS facility-level adjustment factors.
Finally, with respect to the IPF quality reporting program (QRP), CMS proposed adopting the “30-Day Risk-Standardized All-Cause Emergency Department Visit Following an Inpatient Psychiatric Facility Discharge” measure. CMS also proposed requiring patient-level measures data reporting on a quarterly basis.
A display copy of the proposed rule is available here.
