Inpatient psychiatric facilities rule would increase payments 2%, add quality measures

The Centers for Medicare & Medicaid Services April 4 issued a proposed rule for the inpatient psychiatric facility prospective payment system for fiscal year 2024.

CMS proposes to increase IPF payments by a net 1.9%, equivalent to $55 million, in FY 2024. The 1.9% payment update is a reflection of a 3.0% increase based on a proposed 2021-based market-basket update of 3.2% minus a productivity adjustment of 0.2 percentage points. CMS also proposes to update the outlier threshold so that estimated outlier payments remain at 2.0% of total payments. CMS estimates this would result in a 1.0% decrease to aggregate payments due to updating the outlier threshold. The agency also solicits comments to inform revisions to the IPF PPS as required by the Consolidated Appropriations Act of 2023.

In response to increased mental health needs, CMS proposes to allow the status of psychiatric units to be changed from not excluded to excluded (and thus paid under the IPF PPS) at any time during the cost reporting period. 

For the IPF Quality Reporting Program, CMS proposes to adopt four new quality measures, including one on patient experience, and modify another measure related to COVID-19 vaccination among health care personnel. The agency would remove two measures and adopt a data validation pilot as well.

For more details, see the CMS fact sheet. CMS will accept comments on this rule through June 5.