2026 FINAL RULES INPATIENT PSYCH
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
CMS Releases Final FY 2026 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) 2026.
A copy of the 153-page document is available at: https://public-inspection.federalregister.gov/2024-16909.pdf. The rule is scheduled for publication in the August 5 Federal Register.
Addendum A summarizes the fiscal year (FY) 2026 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. In addition, Addendum B shows the complete listing of ICD–10 Clinical Modification (CM) and Procedure
Coding System (PCS) codes, the FY 2026 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/payment/prospective-payment-systems/inpatient-psychiatric-facility/tools-and-worksheets
Tables setting forth the FY 2026 Wage Index for Urban Areas Based on Core Based Statistical Area (CBSA) Labor Market Areas, the FY 2026 Wage Index Based on CBSA Labor Market Areas for Rural Areas, and the FY 2026 CBSA Labor Market Areas are available exclusively through the internet, on the CMS website at: https://www.cms.gov/medicare/payment/prospective-payment-systems/inpatient-psychiatric-facility/wage-index.