{"abstract":"This final rule updates 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 final rule also revises the payment adjustment factors for teaching status and for IPFs located in rural areas. These changes will be effective for IPF discharges occurring during the fiscal year beginning October 1, 2025, through September 30, 2026. We are finalizing changes to measures used in the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, updating and codifying the Extraordinary Circumstances Exception policy, and summarizing comments received through requests for information regarding future changes to the IPFQR Program.","action":"Final 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/2025/08/05/2025-14781.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"412","title":42}],"citation":"90 FR 37628","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"These regulations are effective October 1, 2025.","disposition_notes":null,"docket_ids":["CMS-1831-F"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":0,"comment_start_date":"2025-08-05","updated_at":"2025-08-05T14:56:23.143-04:00","comment_url":"https://www.regulations.gov/commenton/CMS-2025-0029-0060","allow_late_comments":false,"id":"CMS-2025-0029-0060","comment_end_date":null,"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":"2025-14781","effective_on":"2025-10-01","end_page":37676,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2025/08/05/2025-14781.xml","html_url":"https://www.federalregister.gov/documents/2025/08/05/2025-14781/medicare-program-fy-2026-inpatient-psychiatric-facilities-prospective-payment-system-rate-update","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2025-14781?publication_date=2025-08-05","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2025-08-05/2025-14781/mods.xml","not_received_for_publication":null,"page_length":49,"page_views":{"count":2912,"last_updated":"2026-08-23 20:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-08-05/pdf/2025-14781.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-14781.pdf?1754079306","publication_date":"2025-08-05","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2025/08/05/2025-14781.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":0,"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-2025-0029-0060","regulation_id_number":"0938-AV46","title":"FY 2026 Inpatient Psychiatric Facilities Prospective Payment System – Rate Update CMS-1831-P","checked_regulationsdotgov_at":"2025-08-06T21:55:03Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":37628,"subtype":null,"title":"Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update","toc_doc":"FY 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":"Rule","volume":90}