2027 PROPOSED RULES INPATIENT PSYCH
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
CMS Issues Proposed FY 2027 Inpatient Psychiatric Facility PPS Update
The Centers for Medicare and Medicaid Services (CMS) are issuing a proposed rule to update the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS).
The proposal would update the payment rates, the outlier threshold, and the wage index for services provided by Inpatient Psychiatric Facilities (IPFs) for discharges occurring during fiscal year (FY) 2027 (beginning October 1, 2026, through September 30, 2027).
The proposed rule also includes a proposal to limit an IPF’s outlier payments to no more than 20 percent of its total IPF PPS payments in a year.
Lastly, the rule would implement a standardized IPF patient assessment instrument and remove two quality measures.
This rule proposes to update:
· The IPF PPS Federal per diem base rate from $892.87 to $912.58.
· The IPF PPS Federal per diem base rate for providers who failed to report quality data to $894.74.
· The electroconvulsive therapy (ECT) payment per treatment from $673.85 to $688.73.
· The ECT payment per treatment for providers who failed to report quality data to $675.26.
· The labor-related share from 79.0 percent to 79.1 percent.
· The wage index budget neutrality factor to 0.9991.
· The fixed dollar loss threshold amount from $39,360 to $37,820, to maintain estimated outlier payments at 2.0 percent of total estimated aggregate IPF PPS payments.
For the IPF Quality Reporting Program, CMS is proposing to implement a standardized IPF patient assessment instrument (IPF-PAI), as mandated by section 4125(b)(1) of the Consolidated Appropriations Act of 2023 (CAA, 2023), and to remove two measures from the program: Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention (SUB-2/2a) and Tobacco Use Treatment Provided or Offered at Discharge (TOB-3/3a).
A copy of the 115-page display document is available at: https://public-inspection.federalregister.gov/2026-06675.pdf. The rule is scheduled for publication in the April 7 Federal Register, and includes a 60-day comment period.