Today, CMS released the final fiscal year (FY) 2020 Inpatient Psychiatric Facility (IPF) prospective payment system rule. The rule rebalances the market basket used to update IPF payments annually, implements rate updates beginning October 1, 2019, and adds an additional measure to the IPF quality reporting program. CMS estimates that the payment updates will increase payments to IPFs by $65 million in 2020, and that there will be no fiscal impact to the quality reporting changes.

Inpatient Psych Base Rate Increases Slightly

For FY 2020, CMS finalized a per diem base rate for IPFs of $798.55, an increase from the FY 2019 base rate of $782.78. This reflects a rebalanced market basket which incorporates freestanding and hospital-based facilities, rather than the previous freestanding-only-based rate, as well as the elimination of a one-year lag in wage reporting data. The per-treatment payment for electro-convulsive therapy will rise to $343.79 from $337.00.

These rates will be reduced by 2 percent for facilities that do not meet the requirements of the IPF quality reporting program.

New Medication Adherence Quality Measure Added

The final rule updates the IPF Quality Reporting (IPFQR) Program with the addition of a new measure on “medication continuation following discharge” (NQF #3205), which will assess whether admitted patients with major depressive disorder, schizophrenia, or bipolar disorder fill at least one medication to use post-discharge. The new measure will track Medicare fee-for-service claims specifically in the period 2 days prior to discharge through 30 days after discharge.  For FY 2021 payment determination, discharges in the performance period July 1, 2017 and June 30, 2019 will be used.