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.”
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)
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)
MedLearn Matters (MM8889-revised) - "Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Fiscal Year (FY) 2015"
CMS final rule: "Medicare Program: Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2014 (FY15).”
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.
CMS release: First public reporting of quality measures from inpatient psychiatric facilities launched on Hospital Compare
CMS: Inpatient Psychiatric Facility Quality Reporting (IPFQR) Quarterly Newsletter (Vol.1.No.1)
CMS Notice: "Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System - Update for Fiscal Year Beginning October 1, 2013 (FY 2014)."
NAPHS comment letter to CMS: "Medicare: ....Quality Reporting Requirements for Specific Providers (CMS-1599-P)"
CMS proposed rule on quality reporting requirements for inpatient psychiatric facilities (for FY15 payment determination). See page 27734.
CMS notice: "Medicare Program: Inpatient Psychiatric Prospective Payment System; Update for Fiscal Year Beginning October 1, 2012" [View]
MedPAC chapter (Section 6) on specialty inpatient psychiatric facilities (from A Data Book: Health Care Spending and the Medicare Program) [View]
Proposed rule: Medicare program: Changes in size and square footage of inpatient rehab units and inpatient psychiatric units (see p. 24251-2) [View]
MedLearn Matters article (MM7072): Implementation of Edits for the Emergency Department Adjustment Policy under the Inpatient Psychiatric Facility Prospective Payment System [View]
MedLearn Matters: Implementation of the Interrupted Stay Policy Under the Inpatient Psychiatric Facility Prospective Payment Systems (IPF PPS) -- (CR)#: 7044 [View]
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]
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]
OIG "Nationwide Review of Medicare Payments for Interrupted Stays at Inpatient Psychiatric Facilities for CYs 06 and 07" (A-01-09-00508) [View]
CMS email on "Admissions to an IPF" (Are substance abuse treatment services covered in an IPF?) [View]
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]
The FINAL RULE on Medicare's move to an inpatient psychiatric prospective payment system is in the November 15, 2004, Federal Register. [View]
RECURRING: CMS: Inpatient psychiatric facility PPS PC pricers (check periodically for most recent) [View]
RECURRING: CMS: Provider Specific Data for Public Use in text format or SAS format (updated quarterly)
RECURRING: PEPPER Training and Resources