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CMS recently published the FY 2026 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Final Rule which finalized changes to the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program. All IPFs, which include psychiatric hospitals and psychiatric units of an acute care hospital or critical access hospital, paid under the IPF PPS must meet IPFQR reporting requirements. For the full text of the final rule, see the Federal Register.
2026 Inpatient Psychiatric Facilities Prospective Payment System Final Rule
In this final rule CMS finalized the removal of 4 measures beginning with CY 2024 reporting period (FY 2026 payment determination): the COVID-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure; the Facility Commitment to Health Equity (FCHE) measure; and the two Social Drivers of Health measures, the Screening for Social Drivers of Health (SDOH-01) and Screen Positive Rate for Social Drivers of Health (SDOH-02). These measures were removed due to the costs associated with each measure outweighing the benefit of the measure’s continued use in the program.
CMS also finalized modifying the reporting period of the 30-Day Risk-Standardized All Cause Emergency Department (ED) Visit Following an IPF Discharge measure beginning with the FY 2027 payment determination. CMS modified the current 1-year reporting period for the IPF ED Visit measure to a 2-year reporting period to align with the IPF Unplanned Readmission measure reporting period. The 2-year reporting period runs from July 1st, 4 years prior to the applicable fiscal year payment determination, to June 30th, 2 years prior to the applicable fiscal year payment determination. This makes the first reporting period for the measure Q3 CY 2025 – Q2 CY 2027 for the FY 2029 payment determination.
Lastly, CMS finalized updates to the Extraordinary Circumstances (ECE) policy. CMS finalized that an IPF may request an ECE within 60 calendar days of the date that the extraordinary circumstance occurred. The current policy had allowed a request within 90 days, and while CMS proposed shortening this timeframe to 30 days in the IPF PPS Proposed Rule, CMS finalized a change to 60 days following public comment. CMS finalized that CMS notify the requestor with a decision in writing, via email, and will include if the IPF is exempted from one or more reporting requirements or if the IPF is granted an extension of time to comply with one or more reporting requirements.
Looking ahead, CMS solicited feedback on a potential future star rating system for IPFs. Although IPFQR reported data is publicly reported on the Compare tool on Medicare.gov, there are no star ratings displayed for IPFs and IPFs are not included in hospital star ratings. CMS was also interested in feedback to inform future measure development for the IPFQR Program, as CMS’ goal is to re-focus on measurable clinical outcomes and identify quality measures on topics of nutrition and well-being. Lastly, CMS was looking for feedback regarding potential use of the Fast Healthcare Interoperability Resources (FHIR) standard for electronic exchange of healthcare information for patient assessment reporting. CMS will consider comments as they continue to develop policies for future rulemaking.
If you have questions about reporting your IPFQR measures, please contact us.