{"abstract":"This rulemaking proposes to update the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPFs), which include psychiatric hospitals and excluded psychiatric units of an acute care hospital or critical access hospital. This rulemaking also proposes to revise the payment adjustment factors for teaching status and for IPFs located in rural areas. These proposed changes would be effective for IPF discharges occurring during the fiscal year beginning October 1, 2025 through September 30, 2026. We are proposing to make changes to measures used in the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, to update and codify the Extraordinary Circumstances Exception policy, and to solicit feedback through requests for information on future changes to the IPFQR Program.","action":"Proposed rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2025/04/30/2025-06298.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"412","title":42}],"citation":"90 FR 18494","comment_url":null,"comments_close_on":"2025-06-10","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses provided below, by June 10, 2025.","disposition_notes":null,"docket_ids":["CMS-1831-P"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":56,"comment_start_date":"2025-04-30","updated_at":"2025-06-12T01:55:58.176-04:00","comment_url":"https://www.regulations.gov/commenton/CMS-2025-0029-0002","allow_late_comments":false,"id":"CMS-2025-0029-0002","comment_end_date":"2025-06-11","regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2025-0029","title":"FY 2026 Inpatient Psychiatric Facilities Prospective Payment System – Rate Update CMS-1831-P"}],"document_number":"2025-06298","effective_on":null,"end_page":18531,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2025/04/30/2025-06298.xml","html_url":"https://www.federalregister.gov/documents/2025/04/30/2025-06298/medicare-program-fy-2026-inpatient-psychiatric-facilities-prospective-payment-system-rate-update","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2025-06298?publication_date=2025-04-30","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2025-04-30/2025-06298/mods.xml","not_received_for_publication":null,"page_length":38,"page_views":{"count":2928,"last_updated":"2026-07-27 22:15:03 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06298.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-06298.pdf?1744402509","publication_date":"2025-04-30","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2025/04/30/2025-06298.txt","regulation_id_number_info":{"0938-AV46":{"issue":"202504","html_url":"https://www.federalregister.gov/regulations/0938-AV46/fy-2026-inpatient-psychiatric-facilities-prospective-payment-system-rate-and-quality-reporting-updat","title":"FY 2026 Inpatient Psychiatric Facilities Prospective Payment System Rate and Quality Reporting Updates (CMS-1831)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202504&RIN=0938-AV46&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AV46"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AV46/fy-2026-inpatient-psychiatric-facilities-prospective-payment-system-rate-and-quality-reporting-updat","title":"FY 2026 Inpatient Psychiatric Facilities Prospective Payment System Rate and Quality Reporting Updates (CMS-1831)"},"comments_count":56,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2025-0029","supporting_documents_count":0,"docket_id":"CMS-2025-0029","document_id":"CMS-2025-0029-0002","regulation_id_number":"0938-AV46","title":"FY 2026 Inpatient Psychiatric Facilities Prospective Payment System – Rate Update CMS-1831-P","checked_regulationsdotgov_at":"2025-06-13T08:55:03Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":18494,"subtype":null,"title":"Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update","toc_doc":"Fiscal Year 2026 Inpatient Psychiatric Facilities Prospective Payment SystemRate Update","toc_subject":"Medicare Program","topics":["Administrative practice and procedure","Health facilities","Medicare","Puerto Rico","Reporting and recordkeeping requirements"],"type":"Proposed Rule","volume":90}