The federal per diem rate for inpatient psychiatric facilities (IPF) being paid under the prospective payment system (PPS) will be $637.78 and $274.58 for electroconvulsive therapy during rate year (RY) 2009, according to an advance release copy of a Federal Register Notice issued by CMS. The RY 2009 federal per diem rates are being increased by 3.2 percent from the RY 2008 rates. The result being that IPFs will receive an additional $120 million in funding in RY 2009.
The three year transition that paid IPFs a percentage of the PPS amount and a percentage of the cost amount has ended. IPFs with cost reports beginning January 1, 2008 will receive 100 percent of the IPF PPS payment. In addition, because the transition period is over, the stop-loss payments used to ensure that IPFs were paid? no less than a minimum percentage of their payments before the PPS will no longer be made.
The rehabilitation, psychiatric, long-term (RPL) market basket was used to adjust the IPF PPS for RY 2009 because all of these facility types are being paid under a PPS. Previously, the IPF PPS had been adjusted using the hospital market basket based on 1997 cost report data. The RPL market basket uses FY 2002 cost report data from these facilities. Cancer and children's hospitals are excluded from the RPL market basket.
The fixed dollar threshold to qualify for an outlier payment will be $6,311 in RY 2009. This amount will ensure that no more than only -two percent of the claims qualify for the outlier adjustment. Other adjustments will remain the same as previous years: the 17 percent adjustment for IPFs located in rural areas will be continued for RY 2009; the teaching adjustment will remain the same with a 0.5150 coefficient; the adjustment factor for IPFs with an emergency department will be 1.31, the same as RY 2008; and, the wage index will be based of the hospital wage index.
Source: CCH Chicago Bureau, May 2, 2008.
For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.
Visit our News Library to read more news stories.