Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) PC PRICER

Section 124 (c) of Public Law 106-113, the Balance Budget Requirement Act of 1999 (BBRA) required the implementation of a per diem prospective payment system (PPS) for Inpatient Psychiatric Facilities (IPF).  The per diem prospective payment system was implemented for inpatient psychiatric services that are furnished in a psychiatric hospital, units in an acute care hospitals or a critical access hospital.

Under this system, payment to IPFs is based on a Federal per diem base rate that includes both inpatient operating and capital-related costs (including routine and ancillary services) but excludes certain pass-through costs (i.e., bad debt and direct medical education).  The Federal per diem base rate provides patient-level and facility-level adjustments including wage index and teaching adjustments and an add-on for rural facilities.  The payment for an individual patient is further adjusted for factors such as the Diagnosis Related Group classification, age, length of stay, and the presence of specified comorbidities.  Additional payments are provided for cost outlier cases, a qualifying emergency department (ED) and electroconvulsive therapy treatments.  

The IPF PPS PC PRICER makes all reimbursement calculations applicable under the IPF PPS including all payment adjustments, and outlier adjustments. 

Note: To be notified of changes or updates to this PRICER application, select the link for 'Receive IPF PPS PC Pricer Updates' in the Related Links Outside CMS section below.  Subscribe to the IPFPPS-L listserv to receive notifications.

Downloads
Inpatient Psych RY2012.1 [ZIP, 1.41MB] (for claims dates from 10/01/11 to 09/30/12) - Posted 12/07/11 Inpatient Psych RY2012.A [ZIP, 1.41MB] (for claims dates from 07/01/11 to 09/30/11) - Posted 12/01/11 Inpatient Psych RY2011.2 [ZIP, 1.32MB] (for claims dates from 10/01/10 to 06/30/11) - Posted 09/09/11 Inpatient Psych RY2011.C [ZIP, 1.3MB] (for claims dates from 07/01/10 to 09/30/10) - Posted 11/08/10 Inpatient Psych RY2010.2 [ZIP, 1.14MB] (for claims dates from 10/01/09 to 06/30/10) - Posted 07/23/10 Inpatient Psych RY2010.A [ZIP, 1.14MB] (for claims dates from 07/01/09 to 09/30/09) - Posted 04/28/10 Inpatient Psych RY2009.4 [ZIP, 1.3MB] (for claims dates from 10/01/08 to 06/30/09) - Posted 03/05/10 Inpatient Psych RY2009.A [ZIP, 1.14MB] (for claims dates from 07/01/08 to 09/30/08) - Posted 03/05/10 Inpatient Psych RY2008.A, RY 2008.6 and RY 2007 [ZIP, 3.42MB] (for claims dated for multiple years from 07/01/06 to 06/30/08) - Posted 09/01/11 User's Manual [ZIP, 342KB]
Related Links Inside CMS
There are no Related Links Inside CMS
Related Links Outside CMS
Receive IPF PPS PC Pricer Updates

Page Last Modified: 12/07/2011 8:32:50 AM
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