Prospective Payment System (PPS) Inpatient Psych

Section 124(c) of Pub. L. 106-113, the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), directs the implementation of a per diem Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS).

WHA Contact

Brian Potter
Senior Vice President, Finance and Chief Operating Officer
EMAIL: Brian Potter

The IPF PPS must include an "adequate patient classification system" that reflects differences in patient resource use and costs. The Centers for Medicare & Medicaid Services (CMS) is proposing an IPF PPS that uses available administrative data to develop various adjustments to a federal per diem base amount. The adjustments were derived using regression analysis to determine which factors are relevant to predicting patient resources. These payment adjusters include both facility-specific as well as patient-specific adjustments.

Proposed and Final Rules/Summaries