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Tag: IP Psych PPS

Update – IP Psych PPS – FY2017

From: CMS – MLN Matters – MM9732; 8/1/16

What You Need to Know

Change Request (CR) 9732 identifies changes required as part of the annual IPF PPS update from the FY 2017 IPF PPS Notice displayed on July 28, 2016. These changes are applicable to IPF discharges occurring from October 1, 2016, through September 30, 2017. In addition, CR9732 removes two ICD-10 PCS Electroconvulsive Therapy (ECT) codes, GZB1ZZZ and GZB3ZZZ, in accordance with Nation Coverage Determination (NCD) 160.25. Make sure your billing staffs are aware of these IPF PPS changes for FY 2017.

Update – IP Psych PPS – FY2017

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IP Psych PPS FY2017 Rate Update – Notice

 

From: Federal Register CMS-1650-N; Filed 7/28/16; Publication 8/1/16

  1. Executive Summary
  1. Purpose This notice updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the fiscal year (FY) beginning October 1, 2016 through September 30, 2017.
  1. Summary of the Major Provisions In this notice, we are updating the IPF Prospective Payment System (PPS), as specified in 42 CFR 412.428. The updates include the following:
  • Effective for the FY 2016 IPF PPS update, we adopted a 2012-based IPF market basket. For FY 2017, we adjusted the 2012-based IPF market basket update (2.8 percent) by a reduction for economy-wide productivity (0.3 percentage point) as required by section 1886(s)(2)(A)(i) of the Social Security Act (the Act). We further reduced the 2012-based IPF market basket update by 0.2 percentage point as required by section CMS-1650-N 8 1886(s)(2)(A)(ii) of the Act, resulting in an estimated IPF payment rate update of 2.3 percent for FY 2017.
  • The 2012-based IPF market basket resulted in a labor-related share of 75.1 percent for FY 2017.
  • We updated the IPF PPS per diem rate from $743.73 to $761.37. Providers that failed to report quality data for FY 2017 payment will receive a FY 2017 per diem rate of $746.48.
  • We updated the electroconvulsive therapy (ECT) payment per treatment from $320.19 to $327.78. Providers that failed to report quality data for FY 2017 payment will receive a FY 2017 ECT payment per treatment of $321.38.
  • We used the updated labor-related share of 75.1 percent (based on the 2012- based IPF market basket) and CBSA rural and urban wage indices for FY 2017, and established a wage index budget-neutrality adjustment of 1.0007.
  • We updated the fixed dollar loss threshold amount from $9,580 to $10,120 in order to maintain estimated outlier payments at 2 percent of total estimated aggregate IPF PPS payments.

Click here to view the CMS Fact Sheet related to this release.

Click here to go to the CMS IP Psych website containing other supporting files including the FY2017 wage index and  IPF PPS Code First ICD10 Codes and Adjustment Factors

IP Psych PPS FY2017 Rate Update – Notice

 

 

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