2025 FINAL RULES INPATIENT PSYCH
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
CMS Releases Final FY 2025 Inpatient Psychiatric Facility PPS Update
CMS Issues Final FY 2025 Inpatient Psychiatric Facility PPS Update The Centers for Medicare and Medicaid Services (CMS) have issued a final rule to update the Medicare Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) for Fiscal Year (FY) 2025.
A copy of the 233-page document is available at: https://publicinspection.federalregister.gov/2024-16909.pdf. The rule is scheduled for publication in the August 7 Federal Register.
Addendum A summarizes the fiscal year (FY) 2025 IPF PPS payment rates, outlier threshold, cost of living adjustment factors (COLA) for Alaska and Hawaii, national and upper limit cost-to-charge ratios, and adjustment factors.
Addendum B contains the complete listing of ICD–10 Clinical Modification (CM) and Procedure Coding System (PCS) codes, the FY 2025 IPF PPS comorbidity adjustment, and electroconvulsive therapy (ECT) procedure codes.
Addenda A and B are available on the CMS website at: https://www.cms.gov/Medicare/Medicare-Feefor-Service-Payment/InpatientPsychFacilPPS/tools.html.
Tables setting forth the FY 2025 Wage Index for Urban Areas Based on Core Based Statistical Area (CBSA) Labor Market Areas, and the FY 2025 Wage Index Based on CBSA Labor Market Areas for Rural Areas, and a county-level crosswalk of the FY 2024 CBSA Labor Market Areas to the FY 2025 CBSA Labor Market Areas are available at: https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/IPFPPS/WageIndex.html.