CMS Releases Proposed 2025 Inpatient Payment Rule
On April 10, the Centers for Medicare & Medicaid Services (CMS) introduced its 2025 proposed inpatient prospective payment system (IPPS) rule. WHA will analyze the full
more-than 1,900-page rule in the coming weeks and prepare comments in advance of the June 10 comment deadline.
Among the notable items included in the proposal are:
- A 2.6% payment update including a hospital market basket increase of 3.0% offset by a productivity cut of 0.4%.
- Extend a policy to help low-wage index hospitals for at least three more years in an ongoing effort to address wage index disparities.
- Establish a new mandatory CMS Innovation Center model that would provide bundled payment for certain surgical procedures.
- Distribute new graduate medical education slots under section 4122 of the Consolidated Appropriations Act of 2023.
- Seek public comments on the use of Medicare IPPS payments for maternity care by other payers.
- Address drug supply chain disruptions, CMS proposes a separate IPPS payment to help small, independent hospitals maintain a buffer of essential drugs.
- Redesignate several ICD-10 codes related to housing status in keeping with its work on identifying social determinants of health.
- Updates across hospital quality programs, including replacing the COVID-19 and seasonal influenza reporting standards for hospitals and critical access hospitals (CAHs) with a standard addressing acute respiratory illnesses to include RSV:
- Beginning on Oct 1, CMS would require hospitals and CAHs to report data once per week on confirmed infections of COVID-19, influenza and respiratory syntactical virus among hospitalized patients, hospital capacity and limited patient demographic information, including age.
Contact WHA Vice President of Federal and State Relations
Jon Hoelter with questions or comments.