News and Updates

Update: IPF PPS-Update for Fiscal Yr Beg. 10/1/12 (FY 2013)

Posted on: August 27th, 2012 by Michael Freeman

The linked notice (published 8/7/12) updates the PPS rates for Medicare inpatient services provided by inpatient psychiatric facilities (IPF’s).  These changes affect discharges occurring during the FY 2013 (10/1/12-9/30/13).  Major provisions in this update include:

  • The FY 2008-based Rehabilitation, Psychiatric, and Long Term Care (RPL)market basket update of 2.7 percent adjusted by a 0.1 percentage point reduction as required by section 1886(s)(2)(A)(ii) of the Social Security Act (the Act) and a 0.7 percentage point reduction as required by 1886(s)(2)(A)(i) of the Act yielding an increase in the Federal per diem base rate from $685.01 to $698.51 effective 10/1/12.
  • The fixed dollar loss threshold amount in order to maintain the appropriate outlier percentage is now $11,600.
  • The electroconvulsive therapy payment by a factor specified by CMS yielding an ECT rate of $300.72.
  • Adjustment of labor-related share of 69.981% and non-labor related share of 30.019%
  • The national urban and rural cost-to-charge ratio medians and ceilings.
  • Description of the ICD–9–CM and MS–DRG classification changes discussed in the annual update to the hospital inpatient PPS regulations.
  • Use of the best available hospital wage index and information regarding whether an adjustment to the Federal per diem base rate is needed to maintain budget neutrality.  The wage index budget neutrality factor is 1.0007.
  • The MS–DRG listing and comorbidity categories to reflect the ICD–9–CM revisions effective October 1, 2012.
  • Retaining the 17 percent adjustment for IPFs located in rural areas, the 1.31 adjustment for IPFs with a qualifying emergency department, the 0.5150 teaching adjustment to the Federal per diem rate, the MS–DRG adjustment factors and co-morbidity adjustment factors currently being paid to IPFs for RY 2012

A link to the final rule published on August 7, 2012 can be found by clicking here.  Please note the useful wage index and rate tables begin on page 21 of the .pdf