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Inpatient Psychiatric Prospective Payment
Background
News

In January 2005, Medicare’s method of payment for inpatient psychiatric facilities (IPFs) changed from a cost-based system to a prospective payment system (PPS).  The final rule on Medicare's move to an inpatient psychiatric prospective payment system was published in the November 15, 2004, Federal Register.

 

According to the Medicare Payment Advisory Commission (MedPAC), “Medicare beneficiaries with serious mental illnesses or alcohol- and drug-related problems may be treated in specialty inpatient psychiatric facilities (IPFs). Beneficiaries who use IPFs are among the most vulnerable in Medicare. A majority are disabled and low income. They tend to be heavy users of health care services, in part because their mental illnesses may undermine their willingness or ability to comply with recommended care. Often, they have additional medical needs that may complicate their treatment. The services furnished by IPFs are intended to meet the urgent needs of patients experiencing an acute mental health crisis. To qualify as an IPF for Medicare payment, a facility must meet Medicare’s general requirements for acute care hospitals and must be primarily engaged in providing psychiatric services for the diagnosis and treatment of mentally ill persons.”

8/1/2016

Medicare Learning Network (MLN) Matters article (MM9732): “Update—Inpatient Psychiatric Facilities Payment System Fiscal Year 2017.”

8/1/2016

CMS notice: "Medicare Program; FY 2017 Inpatient Psychiatric Facilities Prospective Payment System—Rate Update."  Also see 8.1.16 Medicare Network Learning (MLN) Matters article (MM9732).

4/27/2016

CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities (for FY19 payment determination). See pages 25238-25244 on IPFQR.

10/1/2015

CMS final rule correction: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System—Update for Fiscal Year Beginning October 1, 2014 (FY 2015); Correction"

8/5/2015

CMS final rule: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2015 (FY16)" (including IPF Quality Reporting measures) 

6/23/2015

NAPHS comment letter to CMS on proposed rule: "Inpatient Psychiatric Facilities PPS-Update for Fiscal Year Beginning October 1, 2015 (FY16)" (including IPFQR quality measures)

5/1/2015

CMS proposed rule: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2015 (FY16)." Also see CMS fact sheet.

8/6/2014

CMS final rule:  "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2014 (FY15).”

6/24/2014

NAPHS comment letter to CMS on "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System Update for FY2015 (beginning 10/1/14)."  Includes comments on 1) IPF PPS and 2) proposed IPF Quality Reporting Program measures for future years.

5/6/2014

CMS proposed rule:  "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2014 (FY15).” Also see CMS fact sheet.

4/17/2014

CMS release: First public reporting of quality measures from inpatient psychiatric facilities launched on Hospital Compare

11/19/2013

CMS: Inpatient Psychiatric Facility Quality Reporting (IPFQR) Quarterly Newsletter (Vol.1.No.1)

8/1/2013

CMS Notice: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2013 (FY 2014)." 

6/24/2013

NAPHS comment letter to CMS: "Medicare: ....Quality Reporting Requirements for Specific Providers (CMS-1599-P)"

5/13/2013

NAPHS releases first study to examine readmissions within the Medicare Inpatient Psychiatric Facility Prospective Payment System (IPF PPS). View news release and study.

5/10/2013

CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities (for FY15 payment determination). See page 27734.

8/7/2012

CMS notice: "Medicare Program: Inpatient Psychiatric Prospective Payment System; Update for Fiscal Year Beginning October 1, 2012" [View]

6/1/2012

MedPAC chapter (Section 6) on specialty inpatient psychiatric facilities (from A Data Book: Health Care Spending and the Medicare Program) [View]

4/29/2011

Proposed rule: Medicare program: Changes in size and square footage of inpatient rehab units and inpatient psychiatric units (see p. 24251-2) [View]

2/14/2011

MedLearn Matters article (MM7072): Implementation of Edits for the Emergency Department Adjustment Policy under the Inpatient Psychiatric Facility Prospective Payment System [View]

7/29/2010

MedLearn Matters: Implementation of the Interrupted Stay Policy Under the Inpatient Psychiatric Facility Prospective Payment Systems (IPF PPS) -- (CR)#: 7044 [View]

6/1/2010

MedLearn Matters Special Edition Article (SE1020): "Reminder to Inpatient Psychiatric Facilities to Use Source of Admission Code D for Patient Transfers within the Same Facility" [View]

5/19/2010

OIG "Nationwide Review of Medicare Part A Emergency Department Adjustments for Inpatient Psychiatric Facilities During Calendar Years 2006 and 2007" (A-01-09-00504) [View]

5/4/2010

OIG "Nationwide Review of Medicare Payments for Interrupted Stays at Inpatient Psychiatric Facilities for CYs 06 and 07" (A-01-09-00508) [View]

8/28/2006

CMS email on "Admissions to an IPF" (Are substance abuse treatment services covered in an IPF?) [View]

1/1/2006

CMS changes its online links to information about inpatient psychiatric PPS. Update your "favorites" or bookmarks to go to http://www.cms.gov/InpatientPsychFacilPPS/01_overview.asp for links to information about the IPPPS. [View]

11/15/2004

The FINAL RULE on Medicare's move to an inpatient psychiatric prospective payment system is in the November 15, 2004, Federal Register. [View]

1/1/1990

RECURRING: CMS: Inpatient psychiatric facility PPS PC pricers (check periodically for most recent) [View]

1/1/1990

RECURRING: CMS: Provider Specific Data for Public Use in text format or SAS format (updated quarterly)

1/1/1990

RECURRING: PEPPER Training and Resources

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RECURRING:

 

MedPAC:

 

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