Questions billers ask › What Changed in Medicare's IPF PPS for FY 2026?

What Changed in Medicare's IPF PPS for FY 2026?

Answered from the public Medicare sources on 2026-10-01. The quoted text is the source; the note beneath it is what our AI found. You decide what applies to your claim.

The rule, word for word

“For the IPF PPS, we are finalizing our proposals to: • Revise the facility-level IPF PPS adjustment factors for teaching status and for IPFs located in rural areas. • Make technical rate setting updates: The IPF PPS payment rates will be adjusted annually for input price inflation, as well as statutory and other policy factors. This rule updates: ++ The IPF PPS Federal per diem base rate from $876.53 to $892.87. ++ The IPF PPS Federal per diem base rate for providers who failed to report quality data to $875.44. ++ The electroconvulsive therapy (ECT) payment per treatment from $661.52 to $673.85. ++ The ECT payment per treatment for providers who failed to report quality data to $660.70. ++ The labor-related share from 78.8 percent to 79.0 percent. ++ The wage index budget neutrality factor to 1.0011. This final rule applies a refinement standardization factor of 0.9927. ++ The fixed dollar loss threshold amount from $38,110 to $39,360, to maintain estimated outlier payments at 2 percent of total estimated aggregate IPF PPS payments.”

Federal Register, document 2025-14781, FY 2026 IPF PPS final rule summary (1. Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS))
Published2025-08-05 Captured2025-08-05
sha256:8e353428…64d3166a · Source

What our AI found in the sources

For FY 2026, CMS finalized revised facility-level IPF PPS adjustment factors for teaching status and for rural-location IPFs (based on a new regression using FY 2020-2022 cost and claims data), plus the usual annual rate-setting updates. The Federal per diem base rate rose from $876.53 to $892.87 ($875.44 for facilities that fail to report quality data); the ECT payment per treatment rose from $661.52 to $673.85 ($660.70 for non-reporting facilities); the labor-related share increased from 78.8% to 79.0%; the wage index budget-neutrality factor is 1.0011 with a refinement standardization factor of 0.9927; and the fixed dollar loss threshold rose from $38,110 to $39,360 to keep outlier payments at about 2% of total estimated aggregate IPF PPS payments.

Also cited

Federal Register, document 2025-14781, FY 2026 IPF PPS final rule, Section IV.D.3 (3. Development of the Revised Regression for Facility-Level Refinements)
Published2025-08-05 Captured2025-08-05
sha256:8e353428…64d3166a · Source

If this comes up on one of your claims

The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.

Ask it your own question and get the same thing back: the governing rule, quoted, with a citation that still verifies later.

Ask Verbatim your question