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Rule2026-19946

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; Other Policy Changes; and Adoption of Updated Versions of Certain Health Information Technology Standards; Correction

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Published

September 29, 2026

Effective

October 1, 2026

Issuing agencies

Health and Human Services DepartmentCenters for Medicare & Medicaid Services

Abstract

This document corrects technical and typographical errors in the final rule that appeared in the Federal Register on August 4, 2026 titled "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; Other Policy Changes; and Adoption of Updated Versions of Certain Health Information Technology Standards."

Full Text

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<title>Federal Register, Volume 91 Issue 187 (Tuesday, September 29, 2026)</title>
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[Federal Register Volume 91, Number 187 (Tuesday, September 29, 2026)]
[Rules and Regulations]
[Pages 61328-61343]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-19946]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 412, 413, 415, 419, 495, and 512

Office of the Secretary

45 CFR Part 170

[CMS-1849-CN3 and CMS-0062-CN]
RIN 0938-AV79 and 0938-AV44

Medicare Program; Hospital Inpatient Prospective Payment Systems
for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital
Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027
Rates; Requirements for Quality Programs; Other Policy Changes; and
Adoption of Updated Versions of Certain Health Information Technology
Standards; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical and typographical errors in
the final rule that appeared in the Federal Register on August 4, 2026
titled ``Medicare Program; Hospital Inpatient Prospective Payment
Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital
Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027
Rates; Requirements for Quality Programs; Other Policy Changes; and
Adoption of Updated Versions of Certain Health Information Technology
Standards.''

DATES: This correction is effective October 1, 2026.

FOR FURTHER INFORMATION CONTACT:
Donald Thompson, and Michele Hudson, (410) 786-4487 or
<a href="/cdn-cgi/l/email-protection#4206030102212f316c2a2a316c252d34">[email&#160;protected]</a>, Operating Prospective Payment, MS-DRG Relative
Weights, Wage Index, Hospital Geographic Reclassifications, Graduate
Medical Education, Capital Prospective Payment, Excluded Hospitals,
Medicare Disproportionate Share Hospital (DSH) Payment Adjustment, Sole
Community Hospitals (SCHs), Medicare-Dependent Small Rural Hospital
(MDH) Program, and Low-Volume Hospital Payment Adjustment.
Mady Hue, <a href="/cdn-cgi/l/email-protection#b9d4d8cbd0d5cc97d1ccdcf9dad4ca97d1d1ca97ded6cf">[email&#160;protected]</a>, and Andrea Hazeley,
<a href="/cdn-cgi/l/email-protection#67060903150206490f061d020b021e27040a14490f0f1449000811">[email&#160;protected]</a>, MS-DRG Classifications Issues.
Lily Yuan, <a href="/cdn-cgi/l/email-protection#baf4dfcdeedfd9d2fad9d7c994d2d2c994ddd5cc">[email&#160;protected]</a>, New Technology Add-On Payments
Issues.
Jessica Warren, <a href="/cdn-cgi/l/email-protection#0f656a7c7c666c6e21786e7d7d6a614f6c627c2167677c21686079">[email&#160;protected]</a>, and Lisa Marie Gomez,
<a href="/cdn-cgi/l/email-protection#5d11342e3c103c2f3438731a323038276c1d3e302e7335352e733a322b">[email&#160;protected]</a>, Medicare Promoting Interoperability
Program Issues.

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 2026-15833 of August 4, 2026 (91 FR 49570), there were a
number of technical and typographical errors that are identified and
corrected in this correcting document. The corrections in this
correcting document are applicable to discharges occurring on or after
October 1, 2026, as if they had been included in the document that
appeared in the August 4, 2026 Federal Register.

II. Summary of Errors

A. Summary of Errors in the Preamble

On page 49572, we are correcting a typographical error in the year
for the reduction required by section 1886(m)(6)(B)(iv) of the Act.
On page 49669, we are correcting the number of new ICD-10-PCS
procedure codes and the total number of ICD-10-PCS procedure codes for
FY 2027 as referenced in the 2027 Errata available on the CMS website
at: <a href="https://www.cms.gov/medicare/coding-billing/icd-10-codes">https://www.cms.gov/medicare/coding-billing/icd-10-codes</a>.
Under our methodologies as finalized in the FY 2027 IPPS/LTCH PPS
final rule (91 FR 49570), we exclude rural emergency hospitals (REHs),
including hospitals that subsequently became REHs after the period from
which the data were taken, from certain data and calculations used in
the IPPS ratesetting, including the development of the MS-DRG relative
weights for FY 2027 (91 FR 49672) and the calculation of the
standardized amount (91 FR 50370). In addition, we stated that any
hospital that is designated as an REH by 7 days prior to the
publication of the preliminary wage index public use file (PUF) is
excluded from the calculation of the wage index (91 FR 49791). We
inadvertently treated a current IPPS hospital (CMS Certification Number
(CCN) 250078) as a hospital that had converted to REH status, thereby
erroneously excluding its data from the MS-DRG relative weight
calculation and the wage index. Therefore, we restored the applicable
data for this hospital for these and other ratesetting calculations, as
discussed further in section II.C. of this correcting document.
Therefore, we are making the following corrections:

[[Page 61329]]

<bullet> On page 49672, we are correcting the number of Medicare
discharges from IPPS providers in the FY 2025 MedPAR file used in
calculating the relative weights for FY 2027 due to the correction of
the number of hospitals with REH status.
<bullet> On page 49677, we are correcting the normalization
adjustment factor used in calculating the relative weights for FY 2027
due to the correction of the number of hospitals with REH status and
the conforming changes to the relative weights.
<bullet> On page 49791, we are correcting the total number of
hospitals that were removed from the FY 2027 IPPS wage index due to
conversion to REH status and making a corresponding correction to the
number of hospitals' wage data used to calculate the FY 2027 wage
index.
<bullet> On page 49798, we are correcting the unadjusted national
average hourly wage due to the inadvertent omission of one hospital's
wage data (CCN 250078).
<bullet> On page 49799, due to the inadvertent omission of one
hospital's wage data (CCN 250078), we are correcting the occupational
mix adjusted national average hourly wage, the total number of
Worksheet S-3, Parts II and III hospitals from which we used wage data
and occupational mix surveys used for FY 2027, and we are also
correcting certain values in the table listing the FY 2027 national
average hourly wages for occupational mix nursing subcategories.
On page 49713 and 49717, we are correcting a typographical error in
the ICD-10-CM code for Adult-onset Still's disease.
On page 49750, we are correcting the unique ICD-10-PCS procedure
codes for the Infuse\TM\ Bone Graft beginning in FY 2027, as referenced
in the 2027 Errata available on the CMS website at: <a href="https://www.cms.gov/medicare/coding-billing/icd-10-codes">https://www.cms.gov/medicare/coding-billing/icd-10-codes</a>, for purposes of new
technology add-on payment.
On pages 50036, 50332, and 50453 in the discussions of the Medicare
Promoting Interoperability Program, we are correcting several
typographical and technical errors.

B. Summary of Errors in the Regulations Text

On page 50340, we are correcting technical errors in the amendatory
instructions for Sec. 412.87.
On page 50344, we made errors in the amendatory instructions for
Sec. 413.85(d).
On page 50347, in the regulations text for Sec. 495.40, we are
correcting a technical error.

C. Summary of Errors in the Addendum

As discussed in section II.A. of this correcting document, we
inadvertently treated a current IPPS hospital (CCN 250078) as a
hospital that had converted to REH status, thereby erroneously
excluding its data from the IPPS ratesetting calculations for FY 2027,
including the standardized amount calculations. In addition, we
inadvertently treated one urban hospital (CCN 360068) as rural under
Sec. 412.103 after it timely canceled its request to reclassify as
rural under Sec. 412.103, thereby erroneously including its data in
the Ohio rural wage index and rural floor. After restoring the data of
the excluded hospital (CCN 250078), including the hospital's Medicare
Geographic Classification Review Board (MGCRB) reclassification to
Core-Based Statistical Area (CBSA) 25060 for FY 2027, and making a
correction to reflect the cancelation of the rural classification for
the other hospital (CCN 360068) for FY 2027, we recalculated the MS-DRG
relative weights, all wage indexes (and geographic adjustment factors
(GAFs)), all budget neutrality factors, the fixed-loss cost threshold,
and the national operating standardized amounts and capital Federal
rate.
Due to inadvertently treating a current IPPS hospital as a hospital
that had converted to REH status as described previously, we updated
the calculation of Factor 3 of the uncompensated care payment
methodology for FY 2027 to reflect the updated information for that
IPPS hospital (CCN 250078). This hospital is now projected to be
eligible for Medicare DSH payments for FY 2027, including uncompensated
care payments. We recalculated the total uncompensated care amount for
all DSH-eligible hospitals for FY 2027 to reflect this change. In
addition, because Factor 3 for each hospital reflects that hospital's
uncompensated care amount relative to the uncompensated care amount for
all subsection (d) hospitals that receive a DSH payment for the fiscal
year, we also recalculated Factor 3 for all DSH-eligible hospitals. The
hospital-specific Factor 3 determines the total amount of the
uncompensated care payment a hospital is eligible to receive for a
fiscal year. This hospital-specific payment amount is then used to
calculate the amount of the interim uncompensated care payments a
hospital receives per discharge. Given the very narrowly targeted
update to the information used in the calculation of Factor 3, the
change to the previously calculated Factor 3 for the majority of
hospitals is of limited magnitude. We incorporated the revised
uncompensated care payment amounts for all DSH-eligible hospitals into
our recalculation of the FY 2027 fixed-loss threshold and related
budget neutrality figures.
On page 50383, we made conforming changes to the operating national
average case-weighted cost-to-charge ratios (CCRs) for March 2025 and
March 2026, the 1-year national operating CCR adjustment factor, the
capital national average case-weighted CCRs for March 2025 and March
2026, and the 1-year national capital CCR adjustment factor to reflect
the inclusion of applicable data for the IPPS hospital that had
inadvertently been treated as a hospital that converted to an REH.
Due to the correction of the errors involving CCN 250078 and CCN
360068 discussed previously, we made changes to the following:
<bullet> On page 50374, the table titled ``Summary of FY 2027
Budget Neutrality Factors''.
<bullet> On page 50384, the outlier fixed-loss cost threshold for
FY 2027, total operating Federal payments, total operating outlier
payments, and the outlier adjustment to the capital Federal rate.
<bullet> On page 50386, the table titled ``Changes from FY 2026
Standardized Amounts to the FY 2027 Standardized Amounts''.
On page 50390, in the discussion of the applicable percentage
increases to the hospital-specific rates applicable to SCHs and MDHs,
in the untitled table we are correcting a typographical error in the
applicable percentage increase applied to the standardized amount for a
hospital that did not submit quality data and is not a meaningful
electronic health records (EHR) user.
On pages 50391 and 50394 through 50396, in the discussion of the
determination of the Federal hospital inpatient capital related
prospective payment rate update, due to the correction of the errors
involving CCN 250078 and CCN 360068 discussed previously, we made
conforming corrections to the GAF/DRG budget neutrality factor, the
capital Federal rate, and related figures. As a result of these
changes, we also made conforming corrections in the table showing the
comparison of factors and adjustments for the FY 2026 capital Federal
rate and FY 2027 capital Federal rate.
As discussed previously, we inadvertently treated a current IPPS
hospital as a hospital that had converted to REH status, thereby
erroneously excluding its data from the IPPS wage data used for FY
2027. After restoring the hospital's data (CCN 250078), we

[[Page 61330]]

recalculated the FY 2027 LTCH PPS area wage index values since they are
calculated from the same data we used to compute the FY 2027 acute care
hospital inpatient wage index (91 FR 50397). On pages 50396 and 50399,
we made conforming corrections to the FY 2027 LTCH PPS standard Federal
payment rate area wage level adjustment budget neutrality factor and
the FY 2027 LTCH PPS standard Federal payment rate.
On page 50406, we made conforming changes to the applicable HCO
threshold for site neutral payment rate cases under the LTCH PPS for FY
2027 since it is calculated as the sum of the site neutral payment rate
for the case and the IPPS fixed-loss amount.
On page 50407, in the discussion of computing adjusted LTCH PPS
Federal prospective payments for FY 2027, we made conforming changes to
the FY 2027 LTCH PPS standard Federal payment rate due to the
recalculation of the FY 2027 LTCH PPS standard Federal payment rate
area wage level adjustment budget neutrality factor (discussed
previously) and other conforming changes to the figures in that
discussion.
On page 50409, we are making conforming corrections to the national
adjusted operating standardized amounts and capital standard Federal
payment rate (which also include the rates payable to hospitals located
in Puerto Rico) in Tables 1A, 1B, 1C, and 1D as a result of the
conforming corrections to certain budget neutrality factors, as
previously described. We are also making conforming corrections to the
LTCH PPS standard Federal rate in Table 1E as a result of the
conforming corrections to the wage index budget neutrality factor, as
previously described.

D. Summary of Errors in the Appendices

On pages 50413, 50415 through 50416, 50419 through 50420, 50424
through 50426, 50446 through 50449, 50451 and 50457 through 50458 in
the regulatory impact analyses, we have made conforming corrections to
the factors, values, and tables, and the accompanying discussion of the
changes to payments for operating costs and uncompensated care
payments, capital IPPS, and LTCH PPS payments for FY 2027 as a result
of the technical errors that lead to changes in our calculation of
certain IPPS budget neutrality factors, MS-DRG relative weights, wage
indexes, and other figures as described in sections II.A. and C. of
this correcting document, and for the corrections related to
uncompensated care payments as described in section II.C. of this
correcting document. These conforming corrections include changes to
the following:
<bullet> On pages 50415 through 50416, the table titled ``Table I--
Impact Analysis of Changes on Payments for IPPS Operating Costs and
Uncompensated Care Payments for FY 2027''.
<bullet> On pages 50419 and 50420, the table titled ``Table II--
Impact Analysis of Changes on Average Payments per Discharge for
Operating Costs and Uncompensated Care Payments''.
<bullet> On pages 50448 through 50449, the table titled ``Table
III--Comparison of Total Payments per Case''.
<bullet> On pages 50424 through 50426, the discussion of the
``Medicare DSH Uncompensated Care Payments and Supplemental Payment for
Indian Health Service Hospitals and Tribal Hospitals and Hospitals
Located in Puerto Rico'', including the table titled ``Modeled
Uncompensated Care Payments* and Supplemental Payments for Estimated FY
2027 DSHs by Hospital Type.''
<bullet> On page 50451, the table titled ``Table IV: Impact Of
Payment Rate And Policy Changes To LTCH PPS Payments For LTCH PPS
Standard Federal Payment Rate Cases For FY 2027 (Estimated FY 2026
Payments Compared To Estimated FY 2027 Payments)''.
<bullet> On pages 50457 and 50458, the table titled ``Table X.
Estimated Impact On Small Businesses'' and the accompanying discussion.

E. Summary of Errors in and Corrections to Files and Tables Posted on
the CMS website

We are correcting the errors and making conforming corrections in
the following IPPS tables that are listed on page 50408 of the FY 2027
IPPS/LTCH PPS final rule and are available on the internet on the CMS
website at <a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-ppsFee-for-Service-Payment">https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-ppsFee-for-Service-Payment</a>. The tables that are
available on the internet have been updated to reflect the revisions
discussed in this correcting document.
Table 2.--Case-Mix Index and Wage Index Table by CCN--FY 2027 Final
Rule. As discussed in the previous section, we inadvertently treated a
current IPPS hospital (CCN 250078) as a hospital that had converted to
REH status, thereby erroneously excluding its data from the wage index.
Therefore, we restored this provider to Table 2, which includes all
relevant values for this provider for each column in the table. (We
note CCN 250078 has an MGCRB reclassification to CBSA 25060.) In
addition, as discussed in the previous section, we inadvertently
treated one urban hospital (CCN 360068) as rural under Sec. 412.103
after it timely requested to cancel its request to reclassify as rural
under Sec. 412.103, thereby erroneously including its data in the Ohio
rural wage index and rural floor. Effective for FY 2027, CCN 360068 is
no longer reclassified as rural under Sec. 412.103.
Due to the inadvertent omission of the wage data of one hospital
(CCN 250078) and the inadvertent error in the rural reclassification
status of a hospital (CCN 360068) for FY 2027, we are correcting the
occupational mix adjusted national average hourly wage (as discussed in
section II.A. of this correcting document), and we recalculated all of
the budget neutrality adjustments (as discussed in section II.C. of
this correcting document), including the recalculation of the rural
floor budget neutrality factor, which is the only budget neutrality
factor applied to the FY 2027 wage indexes. Because these changes
affect the calculation of various area wage indexes used to determine
certain budget neutrality factors and hospitals' final wage index value
for FY 2027, we are also making conforming changes to other impacted
wage indexes, including to the imputed floor and outmigration
adjustment (as discussed later in this section) for those wage indexes.
Therefore, we are revising the values, as applicable, in Table 2 based
on all these changes described previously.
Table 3.--Wage Index Table by CBSA--FY 2027 Final Rule. As
discussed previously, we inadvertently treated a current IPPS hospital
(CCN 250078) as a hospital that had converted to REH status, thereby
erroneously excluding its data from the wage index. As also discussed
previously, we made an inadvertent error in the rural reclassification
status of a hospital (CCN 360068) for FY 2027. Therefore, we restored
CCN 250078 to the wage data, revised the treatment of CCN 360068 to
rural, and recalculated the FY 2027 wage indexes (see discussion
earlier in this section regarding the MGCRB reclassification for CCN
250078).
Due to the inadvertent omission of the wage data of one hospital
(CCN 250078) and the inadvertent error in the rural reclassification
status of a hospital (CCN 360068), we are correcting the occupational
mix adjusted national average hourly wage (as discussed in section
II.A. of this correcting document), and we recalculated all of the
budget neutrality adjustments (as discussed in section II.C. of this
correcting document), including the recalculation of the rural floor
budget neutrality factor, which is the only

[[Page 61331]]

budget neutrality factor applied to the FY 2027 wage indexes. Because
these changes affect the area pre- and post- reclassified wage indexes,
we are also making conforming changes to other impacted wage indexes,
including to the imputed floor for those wage indexes. We also are
making corresponding changes to the GAFs for any CBSAs with a wage
index that changed. Therefore, we are revising the values in Table 3 in
the applicable columns based on all these changes described previously.
Table 4A.--List of Counties Eligible for the Out-Migration
Adjustment under Section 1886(d)(13) of the Act--FY 2027 Final Rule.
Due to the inadvertent omission of the wage data of one hospital (CCN
250078) and inadvertent error in the rural reclassification status of a
hospital (CCN 360068) for FY 2027 discussed previously, we are
correcting the occupational mix adjusted national average hourly wage
(as discussed in section II.A. of this correcting document), and we
recalculated all of the budget neutrality adjustments (as discussed in
section II.C. of this correcting document) including the recalculation
of the rural floor budget neutrality factor, which is the only budget
neutrality factor applied to the FY 2027 wage indexes. Because all
these changes affect various area wage indexes (including the post
reclassified wage indexes), we are also making conforming changes to
the other impacted wage indexes, including the imputed floor. As
discussed in the FY 2012 IPPS final rule (76 FR 51601 through 51602) we
calculate the out-migration adjustment using the post-reclassified wage
indexes. Because the wage indexes are one of the inputs used to
determine the out-migration adjustment, the out-migration adjustments
for some counties/hospitals changed. Therefore, we are making
corresponding changes to certain out-migration adjustments listed in
Table 4A.
Table 5.--Final List of Medicare Severity Diagnosis-Related Groups
(MS DRGs), Relative Weighting Factors, and Geometric and Arithmetic
Mean Length of Stay--FY 2027 Final Rule. We are correcting this table
to reflect the recalculation of the relative weights, geometric average
length-of-stay (LOS), and arithmetic mean LOS as a result of the
correction of the number of hospitals with REH status (as discussed in
section II.A. of this correcting document).
Table 8A.--FY 2027 Statewide Average Operating Cost-to-Charge
Ratios (CCRs) for Acute Care Hospitals (Urban and Rural)--FY 2027 Final
Rule. As discussed in section II.A of this correcting document, we
inadvertently treated a current IPPS hospital (CCN 250078) as a
hospital that had converted to REH status, thereby erroneously
excluding its data from the ratesetting. Therefore, we restored this
provider's data and made a conforming change to the FY 2027 Statewide
Average Operating cost-to-charge ratios (CCRs) for Urban Mississippi.
Table 8B.--FY 2027 Statewide Average Capital Cost-to-Charge Ratios
(CCRs) for Acute Care Hospitals--FY 2027 Final Rule. As discussed in
section II.A of this correcting document, we inadvertently treated a
current IPPS hospital (CCN 250078) as a hospital that had converted to
REH status, thereby erroneously excluding its data from the
ratesetting. Therefore, we restored this provider's data and made a
conforming change to the FY 2027 Statewide Average Capital cost-to-
charge ratios (CCRs) for Mississippi.
Table 18.--FY 2027 Medicare DSH Uncompensated Care Payment Factor 3
Amounts. We made corrections to the calculation of Factor 3 of the
uncompensated care payment methodology for FY 2027 to reflect the
corrected information for the IPPS hospital (CCN 250078) that had
inadvertently been treated as a hospital that had converted to an REH.
This hospital is now projected to be eligible for Medicare DSH payments
for FY 2027, including uncompensated care payments.
In addition, we made corrections to the calculation of Factor 3 to
reflect correct merger information for four hospitals. For two
hospitals that merged, CMS inadvertently did not combine the hospitals'
data to determine the new, merged hospital's Factor 3 amount. For two
other hospitals that merged, the merged hospital was not captured in
the final rule's list of merged hospitals due to a CMS data processing
time issue. This notice corrects these issues and makes very minor
updates to Factor 3 accordingly, for the merged hospitals and other
hospitals receiving uncompensated care payments for FY 2027.
We recalculated the total uncompensated care amount for all DSH-
eligible hospitals to reflect these updates. In addition, because the
Factor 3 calculated for each hospital reflects that hospital's
uncompensated care amount relative to the uncompensated care amount for
all subsection (d) hospitals that receive a DSH payment for the fiscal
year, we also recalculated Factor 3 for all DSH-eligible hospitals. The
hospital-specific Factor 3 determines the total amount of the
uncompensated care payment a hospital is eligible to receive for the
fiscal year. This hospital-specific payment amount is then used to
calculate the amount of the interim uncompensated care payments a
hospital receives per discharge. Given the very narrowly targeted
updates to the information used in the calculation of Factor 3, the
change to the previously calculated Factor 3 is of limited magnitude
for the majority of hospitals.
In the FY 2027 IPPS/LTCH PPS final rule's Table 18, we published a
list of hospitals that we identified to be subsection (d) hospitals and
subsection (d) Puerto Rico hospitals projected to be eligible to
receive interim uncompensated care payments for FY 2027. We are
correcting this list and the calculation of Factor 3 of the
uncompensated care payment methodology to reflect the corrected
information for the IPPS hospital that was inadvertently treated as a
hospital that had converted to an REH and the hospital mergers. We are
revising Factor 3 for all hospitals to reflect these corrections. We
are also revising the amount of the total uncompensated care payment
calculated for each DSH-eligible hospital. The total uncompensated care
payment that a hospital receives is used to calculate the amount of the
interim uncompensated care payments the hospital receives per
discharge.
Due to the inadvertent omission of the wage data of one hospital
(CCN 250078), we are also making conforming corrections in the
following LTCH PPS tables that are listed on page 50408 of the FY 2027
IPPS/LTCH PPS final rule and are available on the internet on the CMS
website at <a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.html">https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.html</a> under the list item for
Regulation Number CMS-1849-F. The tables that are available on the
internet have been updated to reflect the revisions discussed in this
final rule correction.
Table 8C.--FY 2027 Statewide Average Total Cost-to-Charge Ratios
(CCRs) for LTCHs (Urban and Rural)--FY 2027 Final Rule. As discussed in
the previous section, we inadvertently treated a current IPPS hospital
as a hospital that had converted to REH status, thereby erroneously
excluding its data from the ratesetting (CCN 250078). Therefore, we
restored this provider's data and made a conforming change to the FY
2027 Statewide Average Total cost-to-charge ratios (CCR) for LTCHs for
Urban Mississippi.

[[Page 61332]]

Table 12A.--LTCH PPS Wage Index for Urban Areas for Discharges
Occurring from October 1, 2026, through September 30, 2027. As
discussed previously, we inadvertently excluded a hospital (CCN 250078)
from the IPPS wage data used to calculate the FY 2027 LTCH PPS wage
index and we are correcting the unadjusted national average hourly wage
(as discussed in section II.A. of this correcting document). This
resulted in a correction to the urban wage index values in Table 12A.
Table 12B.--LTCH PPS Wage Index for Rural Areas for Discharges
Occurring from October 1, 2026, through September 30, 2027. As
discussed previously, we inadvertently excluded a hospital (CCN 250078)
from the IPPS wage data used to calculate the FY 2027 LTCH PPS wage
index and we are correcting the unadjusted national average hourly wage
(as discussed in section II.A. of this correcting document). This
resulted in a correction to the rural wage index values in Table 12B.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

Section 1871(b)(1) of the Social Security Act (the Act) requires
the Secretary to provide for notice of a proposed rule in the Federal
Register and provide a period of not less than 60 days for public
comment. In addition, section 1871(e)(1)(B)(i) of the Act mandates a
30-day delay in effective date after issuance or publication of a rule.
Section 1871(b)(2)(C) of the Act provides an exception from the notice
and 60-day comment period and delay in effective date requirements of
the Act, under the good cause standard set forth in 5 U.S.C. 553(b)(B).
Section 1871(e)(1)(B)(ii) of the Act provides an exception from the
delay in effective date requirements of the Act as well. Section
553(b)(B) authorizes an agency to dispense with normal notice and
comment rulemaking procedures for good cause if the agency makes a
finding that the notice and comment process is impracticable,
unnecessary, or contrary to the public interest, and includes a
statement of the finding and the reasons for it in the rule. In
addition, section 1871(e)(1)(B)(ii) of the Act allows the agency to
avoid the 30-day delay in effective date where the waiver is necessary
to comply with statutory requirements or such delay is contrary to the
public interest and the agency includes in the rule a statement of the
finding and the reasons for it. We believe that this final rule
correction does not constitute a rule that would be subject to the
notice and comment or delayed effective date requirements. This
document corrects technical and typographical errors in the preamble,
regulations text, addendum, tables, and appendices included or
referenced in the FY 2027 IPPS/LTCH PPS final rule but does not make
substantive changes to the policies or payment methodologies that were
adopted in the final rule. As a result, this final rule correction is
intended to ensure that the information in the FY 2027 IPPS/LTCH PPS
final rule accurately reflects the policies adopted in that document.
In addition, even if this were a rule to which the notice and
comment procedures and delayed effective date requirements applied, we
find that there is good cause to waive such requirements. Undertaking
further notice and comment procedures to incorporate the corrections in
this document into the final rule or delaying the effective date would
be contrary to the public interest because it is in the public's
interest for providers to receive appropriate payments in as timely a
manner as possible, and to ensure that the FY 2027 IPPS/LTCH PPS final
rule accurately reflects our policies. Furthermore, such procedures
would be unnecessary, as we are not altering our payment methodologies
or policies, but rather, we are simply implementing correctly the
methodologies and policies that we previously proposed, requested
comment on, and subsequently finalized. This final rule correction is
intended solely to ensure that the FY 2027 IPPS/LTCH PPS final rule
accurately reflects these payment methodologies and policies.
Therefore, we believe we have good cause to waive the notice and
comment and effective date requirements.

IV. Correction of Errors

In FR Doc. 2026-15833 of August 4, 2026 (91 FR 49570), we are
making the following corrections:

A. Corrections of Errors in the Preamble

1. On page 49572, first column, last bullet, last line, the figure
``2027'' is corrected to read ``2026''.
2. On page 49669,
a. Third column, first full paragraph, line 10, the figure
``79,256'' is corrected to read ``79,258''.
b. Middle of the page, in the untitled table, second column,
(1) Second row, the figure ``101'' is corrected to read ``103''.
(2) Last row, the figure ``79,256'' is corrected to read
``79,258''.
3. On page 49672, first column, second full paragraph, line 3, the
figure ``6,961,093'' is corrected to read ``6,967,557''.
4. On page 49677, first column, first partial paragraph, line 6,
the figure ``1.945743'' is corrected to read ``1.945875''.
5. On page 49713,
a. In the table, the first column, second row, ``M06.10'' is
corrected to read ``M06.1''.
b. Following the table, the table is corrected by adding a table
note to read as follows:
``We note that the table in the proposed rule listed the ICD-10-CM
code for Adult-onset Still's disease as M06.10 (Adult-onset Still's
disease). The correct code is M06.1 (Adult-onset Still's disease).''
6. On page 49717, in the table, first column, second row,
``M06.10'' is corrected to read ``M06.1''.
7. On page 49750, lower two-thirds of the page, third column,
second paragraph,
a. Lines 14 and 15, the phrase ``a unique ICD-10-PCS procedure
code'' is corrected to read ``unique ICD-10-PCS procedure codes''.
b. Lines 21 through 27, the phrase ``code XW0U0CC (Introduction of
recombinant human bone morphogenetic protein-2 with collagen scaffold
into joints, open approach, new technology group 12), in combination
with any of the following ICD-10-PCS procedure codes:'' is corrected to
read ``codes XW0U0CC (Introduction of recombinant human bone
morphogenetic protein-2 with collagen scaffold into joints, open
approach, new technology group 12), XW0U3CC (Introduction of
recombinant human bone morphogenetic protein-2 with collagen scaffold
into joints, percutaneous approach, new technology group 12), or
XW0U4CC (Introduction of recombinant human bone morphogenetic protein-2
with collagen scaffold into joints, percutaneous endoscopic approach,
new technology group 12) in combination with any of the following ICD-
10-PCS procedure codes:''.
8. On page 49791, upper third of the page,
a. Second column, second paragraph, line 18, the figure ``7'' is
corrected to read as ``6''.
b. Third column, first partial paragraph, last line, the figure
``3,006'' is corrected to read as ``3,007''.
9. On page 49798, top half of the page, in the untitled table, the
figure ``$58.89'' is corrected to read ``$58.88''.
10. On page 49799,
a. Top quarter of the page,
(1) Second column, second partial paragraph:
(a) Line 3, the figure ``3006'' is corrected to read as ``3007''.

[[Page 61333]]

(b) Line 4, the figure ``2921'' is corrected to read as ``2922''.
(2) Third column, first partial paragraph, line 1, the figures
``(2921/3006)'' is corrected to read as ``(2922/3007)''.
(3) In the untitled table, the figure ``$58.83'' is corrected to
read ``$58.82''.
b. Middle of the page, the untitled table regarding ``Occupational
Mix Nursing Subcategory'' is corrected to read:

------------------------------------------------------------------------
Occupational mix nursing subcategory Average hourly wage
------------------------------------------------------------------------
National RN........................................ $60.41
National LPN and Surgical Technician............... 35.01
National Nurse Aide, Orderly, and Attendant........ 23.53
National Medical Assistant......................... 23.13
National Nurse Category............................ 50.05
------------------------------------------------------------------------

11. On page 50036, second column, second full paragraph, lines 8
and 9, ``so not to underscore'' is corrected to read ``to
underscore.''.
12. On page 50332, third column, last partial paragraph, lines 8
and 9, ``the criteria at 45 CFR 170.315(g)(31), (32), and (33)'' is
corrected to read ``one or more of the criteria at 45 CFR
170.315(g)(31) through (33)''.
13. On page 50453, third column, last full paragraph, line 10, the
reference ``section XIII.B.7.'' is corrected to read ``section
XII.B.7.''.

B. Corrections of Errors in the Regulations Text

0
14. On page 50340, third column, second full paragraph (amendatory
instruction 12 (Sec. 412.87)), lines 1 through 3, the sentence
``Section 412.87 is amended by revising paragraphs (c) introductory
text, (d), and (f) to read as follows:'' is corrected to read as
follows:
``Section 412.87 is amended by--
a. Revising paragraphs (c) introductory text, (c)(1), (d)
introductory text, (d)(1), (f) paragraph heading, and (f)(2); and
b. Removing paragraph (f)(3).
The revisions read as follows.''

0
15. On page 50344, second column, second full paragraph, line 5
(amendatory instruction 28.b), the phrase ``b. Revising paragraphs
(d)(2) and (e)'' is corrected to read ``b. Revising paragraphs
(d)(2)(i), (d)(2)(ii), and (e)''.

0
16. On page 50347, first column, Sec. 495.40, line 5, the phrase
``Through CY 2026, to engage'' is corrected to read ``Through the EHR
reporting period in CY 2025, to engage.''

C. Corrections of Errors in the Addendum

17. On page 50374, the table titled ``Summary of FY 2027 Budget
Neutrality Factors'' is corrected to read as follows:

Summary of FY 2027 Budget Neutrality Factors
------------------------------------------------------------------------

------------------------------------------------------------------------
MS[dash]DRG Reclassification and Recalibration Budget 0.998746
Neutrality Factor..........................................
Cap Policy MS-DRG Weights Budget Neutrality Factor.......... 0.999730
Wage Index Budget Neutrality Factor......................... 1.000196
Reclassification Budget Neutrality Factor................... 0.949333
* Rural Floor Budget Neutrality Factor...................... 0.973452
Cap Policy Wage Index Budget Neutrality Factor.............. 0.999384
Continued Transition for the Discontinuation of the Low-Wage 0.999778
Index Hospital Policy Budget Neutrality Factor.............
------------------------------------------------------------------------
* The rural floor budget neutrality factor is applied to the national
wage indexes while the rest of the budget neutrality adjustments are
applied to the standardized amounts.

18. On page 50383,
a. Second column, last partial paragraph, line 4, the figure
``0.240425'' is corrected to ``0.240448''.
b. Third column:
1. Partial paragraph:
(a) Line 1, the figure ``0.233434'' is corrected to ``0.233484''.
(b) Last line, the figure ``0.970922'' is corrected to
``0.971037''.
2. First full paragraph:
(a) Line 5, the figure ``0.016402'' is corrected to ``0.016396''.
(b) Line 6, the figure ``0.01528'' is corrected to ``0.015278''.
(c) Last line, the figure ``0.931594'' is corrected to
``0.931813''.
19. On page 50384,
a. Top half of the page,
(1) First column, partial paragraph:
(a) Line 24, the figure ``$49,346'' is corrected to ``$49,331''.
(b) Lines 25 and 26, the figure ``$4,660,920,375'' is corrected to
``$4,665,006,980'', and
(c) Line 27, the figure ``$86,015,121,737'' is corrected to
``$86,090,968,717''.
(2) Second column, first partial paragraph:
(a) Line 13, the figure ``$49,728'' is corrected to ``$49,713''.
(b) Line 22, the figure ``$49,346'' is corrected to ``$49,331''.
b. Middle of the page, in the untitled table, first row, third
column (Capital Federal Rate*), the figure ``0.967684'' is corrected to
read ``0.967699''.
20. On page 50386, the table titled ``Changes From FY 2026
Standardized Amounts To The FY 2027 Standardized Amounts'' is corrected
to read as follows:

Changes From FY 2026 Standardized Amounts to the Fy 2027 Standardized Amounts
----------------------------------------------------------------------------------------------------------------
Hospital submitted Hospital did not Hospital did not
Hospital submitted quality data and submit quality submit quality
quality data and is not a data and is a data and is not a
is a meaningful meaningful EHR meaningful EHR meaningful EHR
EHR user user user user
----------------------------------------------------------------------------------------------------------------
FY 2026 Base Rate after If Wage Index is If Wage Index is If Wage Index is If Wage Index is
removing: Greater Than Greater Than Greater Than Greater Than
1.0000: 1.0000: 1.0000: 1.0000:
1. FY 2026 Geographic Labor (66.0%): Labor (66.0%): Labor (66.0%): Labor (66.0%):
Reclassification Budget $4,914.60. $4,914.60. $4,914.60. $4,914.60.
Neutrality (0.956835).
2. FY 2026 Operating Outlier Nonlabor (34.0%): Nonlabor (34.0%): Nonlabor (34.0%): Nonlabor (34.0%):
Offset (0.949). $2,531.76. $2,531.76. $2,531.76. $2,531.76.
3. FY 2026 Cap Policy Wage If Wage Index is If Wage Index is If Wage Index is If Wage Index is
Index Budget Neutrality less Than or less Than or less Than or less Than or
Factor (0.999397). Equal to 1.0000: Equal to 1.0000: Equal to 1.0000: Equal to 1.0000:
4. Transition for the Labor (62%): Labor (62%): Labor (62%): Labor (62%):
Discontinuation of the Low $4,616.74. $4,616.74. $4,616.74. $4,616.74.
Wage Index Hospital Policy
Budget Neutrality Factor
(0.999726).
5. FY 2026 Rural Nonlabor (38%): Nonlabor (38%): Nonlabor (38%): Nonlabor (38%):
Demonstration Budget $2,829.62. $2,829.62. $2,829.62. $2,829.62.
Neutrality Factor
(0.999552).
FY 2027 Update Factor........... 1.023............. 0.999............. 1.015............. 0.991.
FY 2027 MS[dash]DRG 0.998746.......... 0.998746.......... 0.998746.......... 0.998746.
Reclassification and
Recalibration Budget Neutrality
Factor Before Cap.

[[Page 61334]]

FY 2027 Cap Policy MS-DRG Weight 0.999730.......... 0.999730.......... 0.999730.......... 0.999730.
Budget Neutrality Factor.
FY 2027 Wage Index Budget 1.000196.......... 1.000196.......... 1.000196.......... 1.000196.
Neutrality Factor.
FY 2027 Reclassification Budget 0.949333.......... 0.949333.......... 0.949333.......... 0.949333.
Neutrality Factor.
FY 2027 Cap Policy Wage Index 0.999384.......... 0.999384.......... 0.999384.......... 0.999384.
Budget Neutrality Factor.
FY 2027 Transition for the 0.999778.......... 0.999778.......... 0.999778.......... 0.999778.
Discontinuation of the Low Wage
Index Hospital Policy Budget
Neutrality Factor.
FY 2027 Operating Outlier Factor 0.949............. 0.949............. 0.949............. 0.949.
National Standardized Amount for Labor: $4,519.68.. Labor: $4,413.65.. Labor: $4,484.34.. Labor: $4,378.30.
FY 2027 if Wage Index is Nonlabor: Nonlabor: Nonlabor: Nonlabor:
Greater Than 1.0000; Labor/Non- $2,328.32. $2,273.70. $2,310.11. $2,255.49.
Labor Share Percentage (66.0/
34.0).
National Standardized Amount for Labor: $4,245.76.. Labor: $4,146.16.. Labor: $4,212.56.. Labor: $4,112.95.
FY 2027 if Wage Index is Less Nonlabor: Nonlabor: Nonlabor: Nonlabor:
Than or Equal to 1.0000; Labor/ $2,602.24. $2,541.19. $2,581.89. $2,520.84.
Non-Labor Share Percentage (62/
38).
----------------------------------------------------------------------------------------------------------------

21. On page 50390, bottom half of page, the untitled table is
corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
Hospital Hospital Hospital did Hospital did
submitted submitted not submit not submit
quality data quality data quality data quality data
FY 2027 and is a and is not a and is a and is not a
meaningful EHR meaningful EHR meaningful EHR meaningful EHR
user user user user
----------------------------------------------------------------------------------------------------------------
Market Basket Rate-of-Increase.................. 3.2 3.2 3.2 3.2
Adjustment for Failure to Submit Quality Data 0 0 -0.8 -0.8
under Section 1886(b)(3)(B)(viii) of the Act...
Adjustment for Failure to be a Meaningful EHR 0 -2.4 0 -2.4
User under Section 1886(b)(3)(B)(ix) of the Act
Productivity Adjustment under Section -0.9 -0.9 -0.9 -0.9
1886(b)(3)(B)(xi) of the Act...................
Applicable Percentage Increase Applied to 2.3 -0.1 1.5 -0.9
Standardized Amount............................
----------------------------------------------------------------------------------------------------------------

22. On page 50391:
a. First column, third full paragraph:
(1) Line 6, the figure ``3.03 percent'' is corrected to read ``3.01
percent''.
(2) Line 10, the figure ``3.0'' is corrected to read ``2.9''.
23. On page 50394,
a. First column, first full paragraph, lines 7 and 8, the
mathematical phrase, ``(0.9916) is 0.9901 (0.9984 x 0.9916)'' is
corrected to read ``(0.9915) is 0.9899 (0.9984 x 0.9915)''.
b. Second column:
(1) First full paragraph, line 2, the figure ``0.9901'' is
corrected to read ``0.9899''.
(2) Second paragraph, line 8, the figure ``$540.03'' is corrected
to read ``$539.95''.
c. Third column:
(1) Last bulleted paragraph, line 10, the figure ``0.9901'' is
corrected to read ``0.9899''.
(2) Last paragraph:
(a) Line 12, the figure ``0.99'' is corrected to read ``1.0''.
(b) Line 22, the figure ``3.03'' is corrected to read ``3.01''.
d. Bottom of the page, the table titled ``Comparison Of Factors And
Adjustments: FY 2026 Capital Federal Rate And The FY 2027 Capital
Federal Rate'' is corrected to read as follows:

Comparison of Factors and Adjustments: FY 2026 Capital Federal Rate and the FY 2027 Capital Federal Rate
----------------------------------------------------------------------------------------------------------------
FY 2026 FY 2027 Change Percent change
----------------------------------------------------------------------------------------------------------------
Update Factor \1\............................... 1.0280 1.034 1.034 3.4
GAF/DRG Adjustment Factor \1\................... 0.9918 0.9899 0.9899 -1.0
GAF Cap/Transition Adjustment Factor \2\........ 0.9989 0.9990 1.0001 0.01
Outlier Adjustment Factor \3\................... 0.9616 0.9677 1.0063 0.63
Capital Federal Rate............................ $524.15 539.95 1.0301 3.01
----------------------------------------------------------------------------------------------------------------
\1\ The update factor and the GAF/DRG budget neutrality adjustment factors are built permanently into the
capital Federal rate. Thus, for example, the incremental change from FY 2026 to FY 2027 resulting from the
application of the 0.9899 GAF/DRG budget neutrality adjustment factor for FY 2027 is a net change of 0.9899
(or -1.0 percent).
\2\ The GAF Cap/Transition budget neutrality adjustment factor is not built permanently into the capital Federal
rate; that is, the factor is not applied cumulatively in determining the capital Federal rate. Thus, for
example, the net change resulting from the application of the FY 2027 GAF Cap/Transition budget neutrality
adjustment factor is 0.9990/0.9989 or 1.0001 (or 0.01 percent).
\3\ The outlier reduction factor is not built permanently into the capital Federal rate; that is, the factor is
not applied cumulatively in determining the capital Federal rate. Thus, for example, the net change resulting
from the application of the FY 2027 outlier adjustment factor is 0.9677/0.9616 or 1.0063 (or 0.63 percent).
\4\ Percent change may not sum due to rounding.

[[Page 61335]]

24. On page 50395, first column, first paragraph, last line, the
figure ``$49,346'' is corrected to read ``$49,331''.
25. On page 50396, first column, second paragraph:
a. Line 35, the figure ``1.002679'' is corrected to read
``1.0025669''.
b. Line 47, the figure ``$52,132.76'' is corrected to read
``$52,126.94''.
c. Line 48, the figure ``1.002679'' is corrected to read
``1.0025669''.
d. Line 54, the figure ``$51,113.55'' is corrected to read
``$51,107.84''.
e. Last line, the figure ``1.002679'' is corrected to read
``1.0025669''.
26. On page 50399, second column, first full paragraph, lines 6 and
9, the figure ``1.002679'' is corrected to read ``1.0025669''.
27. On page 50406, second column, first full paragraph,
a. Line 8, the figure ``$49,346'' is corrected to read ``$49,331''.
b. Last line, the figure ``$49,346'' is corrected to read
``$49,331''.
28. On page 50407, third column,
a. First partial paragraph, line 11, the figure ``$52,132.76'' is
corrected to read ``$52,126.94''.
b. Second paragraph, line 7, the figure ``1.0102'' is corrected to
read ``1.0104''.
c. Third paragraph:
(1) Line 7, the figure ``$52,132.76'' is corrected to read
``$52,126.94''.
(2) Line 9, the figure ``1.0102'' is corrected to read ``1.0104''.
(3) Line 19, the figure ``$50,829.77'' is corrected to read
``$50,831.46''.
d. Bottom of page, the table titled ``Example: LTCH's Total
Adjusted Federal Prospective Payment'' is corrected to read as follows:

Example--LTCH'S Total Adjusted Federal Prospective Payment
------------------------------------------------------------------------

------------------------------------------------------------------------
Unadjusted LTCH PPS Standard Federal Prospective Payment $52,126.94
Rate...................................................
Labor-Related Share..................................... x 0.730
Labor-Related Portion of the LTCH PPS Standard Federal = $38,052.67
Payment Rate...........................................
Wage Index (CBSA 16984)................................. x 1.0104
Wage-Adjusted Labor Share of the LTCH PPS Standard = $38,448.42
Federal Payment Rate...................................
Nonlabor-Related Portion of the LTCH PPS Standard + $14,074.27
Federal Payment Rate ($52,126.94 x 0.270)..............
Adjusted LTCH PPS Standard Federal Payment Amount....... = $52,522.69
MS-LTC-DRG 189 Relative Weight.......................... x 0.9678
Total Adjusted LTCH PPS Standard Federal Prospective = $50,831.46
Payment................................................
------------------------------------------------------------------------

29. On page 50409,
a. The table titled ``Table 1A.--National Adjusted Operating
Standardized Amounts, Labor/Nonlabor (66.0 Percent Labor Share/34.0
Percent Nonlabor Share If Wage Index Is Greater Than 1)--FY 2027 Final
Rule'' is corrected to read as follows:

Table 1A--National Adjusted Operating Standardized Amounts, Labor/Nonlabor (66.0 Percent Labor Share/34.0
Percent Nonlabor Share if Wage Index is Greater Than 1)--FY 2027 Final Rule
----------------------------------------------------------------------------------------------------------------
Hospital submitted quality Hospital submitted quality Hospital did not submit Hospital did not submit
data and is a meaningful EHR data and is not a quality data and is a quality data and is not a
user (update = 2.3 percent) meaningful EHR user meaningful EHR user meaningful EHR user
----------------------------- (update = -0.1 percent) (update = 1.5 percent) (update = -0.9 percent)
-----------------------------------------------------------------------------------
Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor
----------------------------------------------------------------------------------------------------------------
$4,519.68 $2,328.32 $4,413.65 $2,273.70 $4,484.34 $2,310.11 $4,378.30 $2,255.49
----------------------------------------------------------------------------------------------------------------

b. The table titled ``Table 1B.--National Adjusted Operating
Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent
Nonlabor Share If Wage Index Is Less Than Or Equal To 1)--FY 2027 Final
Rule'' is corrected to read as follows:

Table 1B--National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent
Nonlabor Share if Wage Index is Less Than or Equal to 1)--FY 2027 Final Rule
----------------------------------------------------------------------------------------------------------------
Hospital submitted quality Hospital submitted quality Hospital did not submit Hospital did not submit
data and is a meaningful EHR data and is not a quality data and is a quality data and is not a
user (update = 2.3 percent) meaningful EHR user meaningful EHR user meaningful EHR user
----------------------------- (update = -0.1 percent) (update = 1.5 percent) (update = -0.9 percent)
-----------------------------------------------------------------------------------
Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor
----------------------------------------------------------------------------------------------------------------
$4,245.76 $2,602.24 $4,146.16 $2,541.19 $4,212.56 $2,581.89 $4,112.95 $2,520.84
----------------------------------------------------------------------------------------------------------------

c. The table titled ``Table 1C.--Adjusted Operating Standardized
Amounts For Hospitals In Puerto Rico, Labor/Nonlabor (National: 62
Percent Labor Share/38 Percent Nonlabor Share Because Wage Index Is
Less Than Or Equal To 1);--FY 2027 Final Rule'' is corrected to read as
follows:

Table 1C--Adjusted Operating Standardized Amounts For Hospitals In Puerto Rico, Labor/Nonlabor (National: 62
Percent Labor Share/38 Percent Nonlabor Share Because Wage Index Is Less Than Or Equal To 1);--FY 2027 Final
Rule
----------------------------------------------------------------------------------------------------------------
Rates if wage index greater than Hospital is a Hospital is not a
1 meaningful EHR user meaningful EHR user
----------------------------------- and wage index less and wage index less
than or equal to 1 than or equal to 1
(update = 2.3 percent) (update = -0.1
Labor Nonlabor ------------------------ percent)
-----------------------
Labor Nonlabor Labor Nonlabor
----------------------------------------------------------------------------------------------------------------
National \1\................. Not Applicable.. Not Applicable. $4,245.76 $2,602.24 $4,146.16 $2,541.19
----------------------------------------------------------------------------------------------------------------
\1\ For FY 2027, there are no CBSAs in Puerto Rico with a national wage index greater than 1.

[[Page 61336]]

d. The table titled ``Table 1D.--Capital Standard Federal Payment
Rate--FY 2027 Final Rule'' is corrected to read as follows:

Table 1D--Capital Standard Federal Payment Rate--FY 2027 Final Rule
------------------------------------------------------------------------
Rate
------------------------------------------------------------------------
National.................................................... $539.95
------------------------------------------------------------------------

e. The table titled ``Table 1E.--LTCH PPS Standard Federal Payment
Rate--FY 2027 Final Rule'' is corrected to read as follows:

Table 1E--LTCH PPS Standard Federal Payment Rate--FY 2027 Final Rule
------------------------------------------------------------------------
Reduced update
Full update * (0.3
(2.3 percent) percent)
------------------------------------------------------------------------
Standard Federal Rate................... $52,126.94 $51,107.84
------------------------------------------------------------------------
* For LTCHs that fail to submit quality reporting data for FY 2027 in
accordance with the LTCH Quality Reporting Program (LTCH QRP), the
annual update is reduced by 2.0 percentage points as required by
section 1886(m)(5) of the Act.

D. Correction of Errors in the Appendices

30. On page 50413, second column, last paragraph, line 1, the
figure ``3,005'' is corrected to read ``3,006''.
31. On pages 50415 through 50416, the table titled ``Table I.--
Impact Analysis Of Changes On Payments For IPPS Operating Costs And
Uncompensated Care Payments For FY 2027'' is corrected to read as
follows:

Table I--Impact Analysis of Changes on Payments For IPPS Operating Costs and Uncompensated Care Payments for FY 2027
--------------------------------------------------------------------------------------------------------------------------------------------------------
FY 2027
weights and
DRG changes
Number of FY 2027 FY 2027 FY 2027 with All FY
hospitals outlier hospital MDH uncompensated application FY 2027 2027
\1\ payments rate expiration care payments of wage index changes
update recalibration
budget
neutrality
.......... (1) \2\ (2) \3\ (3) \4\ (4) \5\ (5) \6\ (6) \7\ (7) \8\
--------------------------------------------------------------------------------------------------------------------------------------------------------
All Hospitals................................. 3,006 -0.6 2.2 -0.1 0.2 0.0 0.0 1.7
By Geographic Location:
Urban hospitals............................... 2,358 -0.7 2.2 -0.1 0.2 0.0 0.0 1.8
Rural hospitals............................... 648 -0.2 2.2 -0.5 -0.1 -0.4 0.0 1.1
Bed Size (Urban):
0-99 beds..................................... 640 -0.5 2.2 -1.4 0.1 0.0 -0.2 0.1
100-199 beds.................................. 673 -0.6 2.2 -0.1 0.1 -0.2 0.0 1.5
200-299 beds.................................. 400 -0.5 2.2 0.0 0.2 -0.1 -0.1 1.6
300-499 beds.................................. 394 -0.6 2.2 0.0 0.2 0.0 -0.1 1.6
500 or more beds.............................. 249 -0.7 2.1 0.0 0.4 0.2 0.2 2.1
Bed Size (Rural):
0-49 beds..................................... 309 -0.2 2.1 -0.9 0.0 -0.5 -0.1 0.3
50-99 beds.................................... 174 -0.2 2.2 -1.2 0.0 -0.5 0.1 0.5
100-149 beds.................................. 95 -0.2 2.2 0.0 -0.1 -0.4 -0.1 1.4
150-199 beds.................................. 41 -0.2 2.2 0.0 -0.3 -0.3 0.1 1.4
200 or more beds.............................. 29 -0.4 2.2 0.0 0.0 -0.2 0.2 1.9
Urban by Region:
New England................................... 102 -0.6 2.2 -0.1 0.1 0.0 0.3 1.9
Middle Atlantic............................... 272 -0.7 2.2 -0.1 0.3 -0.1 1.0 2.7
East North Central............................ 364 -0.5 2.2 -0.2 0.0 0.0 0.7 2.2
West North Central............................ 155 -0.5 2.2 0.0 -0.1 0.1 -0.9 0.7
South Atlantic................................ 393 -0.6 2.1 -0.1 0.3 0.0 0.5 2.3
East South Central............................ 140 -0.6 2.1 0.0 0.3 0.1 -1.0 0.9
West South Central............................ 356 -0.5 2.0 0.0 0.8 0.1 -0.3 2.0
Mountain...................................... 177 -0.6 2.2 0.0 0.4 0.1 -0.8 1.4
Pacific....................................... 347 -1.0 2.2 0.0 0.1 0.0 -1.0 0.4
Rural by Region:
New England................................... 19 -0.5 2.3 -1.1 0.1 -0.3 1.0 1.6
Middle Atlantic............................... 46 -0.3 2.2 -0.1 0.1 -0.4 -0.1 1.4
East North Central............................ 104 -0.3 2.2 -1.2 -0.1 -0.3 0.9 1.2
West North Central............................ 71 -0.2 2.2 -0.3 -0.2 -0.3 -0.5 0.7
South Atlantic................................ 110 -0.2 2.1 -0.5 -0.3 -0.4 0.5 1.1
East South Central............................ 119 -0.2 2.1 -0.3 0.1 -0.3 -0.9 0.5
West South Central............................ 114 -0.2 2.1 -0.1 -0.2 -0.3 -0.4 0.9
Mountain...................................... 41 -0.1 2.3 0.0 0.2 -0.1 0.1 2.3
Pacific....................................... 24 -0.2 2.3 0.0 0.0 -0.6 -0.4 1.2
Puerto Rico
Puerto Rico Hospitals......................... 52 -0.3 1.4 0.0 0.2 -0.1 -1.8 -0.5
By Payment Classification:
Urban hospitals............................... 1,526 -0.6 2.2 0.0 0.3 -0.1 -0.3 1.5
Rural areas................................... 1,480 -0.6 2.2 -0.1 0.2 0.0 0.2 1.9

[[Page 61337]]

Teaching Status:
Nonteaching................................... 1,696 -0.6 2.2 -0.3 0.1 -0.1 -0.1 1.2
Fewer than 100 residents...................... 1,004 -0.6 2.2 -0.1 0.1 -0.1 -0.1 1.6
100 or more residents......................... 306 -0.7 2.1 0.0 0.4 0.2 0.2 2.2
Urban DSH:
Non-DSH....................................... 370 -0.6 2.3 -0.1 0.0 0.0 0.2 1.9
100 or more beds.............................. 829 -0.7 2.1 0.0 0.4 -0.1 -0.4 1.4
Less than 100 beds............................ 327 -0.5 2.1 0.0 0.1 -0.3 -0.2 1.1
Rural DSH:
Non-DSH....................................... 130 -0.5 2.3 -1.3 0.0 0.0 0.2 0.7
SCH........................................... 212 -0.1 2.2 0.0 0.0 -0.4 0.2 2.0
RRC........................................... 922 -0.6 2.1 0.0 0.2 0.1 0.2 1.9
100 or more beds.............................. 31 -0.6 2.1 -0.1 0.3 0.1 0.9 2.7
Less than 100 beds............................ 185 -0.2 2.1 -2.4 0.0 -0.5 0.1 -1.1
Urban teaching and DSH:
Both teaching and DSH......................... 482 -0.6 2.1 0.0 0.4 -0.1 -0.2 1.7
Teaching and no DSH........................... 68 -0.6 2.3 -0.3 0.0 -0.1 0.3 1.7
No teaching and DSH........................... 674 -0.7 2.2 0.0 0.2 -0.2 -0.6 0.9
No teaching and no DSH........................ 302 -0.6 2.3 0.0 0.0 0.2 0.2 2.1
Special Hospital Types:
SCH........................................... 419 -0.2 2.3 0.0 0.0 -0.3 0.1 1.9
MDH........................................... 166 -0.2 2.2 -8.3 0.0 -0.4 0.1 -6.7
Type of Ownership:
Voluntary..................................... 1,905 -0.6 2.2 -0.1 0.2 0.0 0.1 1.7
Proprietary................................... 693 -0.4 2.2 0.0 0.1 0.0 -0.4 1.4
Government.................................... 406 -0.7 2.0 0.0 0.7 0.1 -0.1 2.0
Medicare Utilization as a Percent of Inpatient
Days:
0-25.......................................... 1,664 -0.6 2.1 0.0 0.4 0.0 0.0 1.9
25-50......................................... 1,266 -0.6 2.2 -0.2 0.0 -0.1 0.1 1.5
50-65......................................... 41 -0.4 2.3 -0.1 0.0 0.0 0.6 2.3
Over 65....................................... 9 -0.2 2.3 -4.6 0.0 0.7 -0.2 -2.1
Medicaid Utilization as a Percent of Inpatient
Days:
0-25.......................................... 2,038 -0.6 2.2 -0.1 0.1 0.0 0.1 1.7
25-50......................................... 860 -0.7 2.1 0.0 0.3 0.1 -0.1 1.8
50-65......................................... 84 -0.7 1.8 0.0 1.4 -0.2 -0.7 1.7
Over 65....................................... 24 -0.9 2.1 0.0 0.2 -0.2 -1.6 -0.4
FY 2027 Reclassifications:
All Reclassified Hospitals.................... 1,104 -0.6 2.2 -0.1 0.2 0.0 0.2 1.9
Non-Reclassified Hospitals.................... 1,902 -0.6 2.1 -0.1 0.2 -0.1 -0.2 1.5
Urban Hospitals Reclassified.................. 977 -0.6 2.2 -0.1 0.2 0.1 0.2 1.9
Urban Non-reclassified Hospitals.............. 1,399 -0.7 2.2 0.0 0.3 -0.1 -0.3 1.4
Rural Hospitals Reclassified Full Year........ 272 -0.2 2.2 -0.2 -0.1 -0.4 -0.1 1.2
Rural Non-reclassified Hospitals Full Year.... 358 -0.3 2.2 -0.6 0.0 -0.4 0.3 1.2
All hospitals that reclassified from urban to 884 -0.6 2.2 -0.1 0.2 0.1 0.2 1.9
rural in accordance with section
1886(d)(8)(E) as implemented at 42 CFR
412.103......................................
Other Reclassified Hospitals (Section 52 -0.3 2.2 -1.6 0.1 -0.5 0.0 -0.1
1886(d)(8)(B), also known as Lugar hospitals)
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Because data necessary to classify some hospitals by category were missing, the total number of hospitals in each category may not equal the
national total. Discharge data are from FY 2025, and hospital cost report data are from the latest available reporting periods.
\2\ This column displays the effects of estimated outlier payments returning to their targeted levels in FY 2027 as compared to the estimated outlier
payments for FY 2026.
\3\ This column displays the payment impact of the hospital rate update, including the 2.3 percent update to the national standardized amount and the
hospital-specific rate (the 3.2 percent IPPS market basket rate-of-increase reduced by the 0.9 percentage point for the productivity adjustment).
\4\ This column displays the impact of the expiration of the MDH status on January 1, 2027, a non-budget neutral payment provision.
\5\ This column displays the effects of the changes to estimated uncompensated care payments in FY 2027 as compared to FY 2026 as a percent change in
estimated total payments. See also the table in section I.G.2 of this Appendix.
\6\ This column displays the payment impact of Version 44 GROUPER, the changes to the relative weights and the recalibration of the MS-DRG weights based
on FY 2025 MedPAR data, and the 10-percent cap where the relative weight for a MS-DRG will decrease by more than ten percent in a given fiscal year.
This column displays the application of the recalibration budget neutrality factor and the 10-percent cap budget neutrality factor (which can be found
in section II.A.4 of the Addendum of this final rule).
\7\ This column displays the effects of the changes to the FY 2027 wage index. This includes: (1) the update to wage index data using FY 2023 cost
report data, the application of the wage index budget neutrality factor and the update to the labor and nonlabor shares; (2) the effects of geographic
reclassifications by the Medicare Geographic Classification Review Board (MGCRB), showing the payment impact of going from FY 2026 reclassifications
to the reclassifications scheduled to be in effect for FY 2027; (3) the effects of the application of the rural floor; (4) the effects of urban to
rural reclassifications under section 1886(d)(8) of the Act on the wage index; (5) the effects of the application of ``LUGAR'' status under section
1886(d)(10) of the Act on the wage index; and (6) the adjustments to the wage index driven by non-budget neutral policies. These non-budget neutral
policies include: (a) the imputed floor for all-urban states; (b) the policy that requires hospitals located in frontier States have a wage index no
less than 1.0; and (c) the policy which provides for an increase in a hospital's wage index if a threshold percentage of residents of the county where
the hospital is located commute to work at hospitals in counties with higher wage indexes. The budget neutrality factors for the effects that are
budget neutral can be found in section II.A.4 of the Addendum of this final rule. This column also displays the redistributive effects of the budget
neutral transition for the discontinuation of the low wage index hospital policy from hospitals that do not benefit from the transition to hospitals
that do benefit (primarily all the hospitals located in Puerto Rico) due to the associated budget neutrality factor. The budget neutrality factor for
the transition can be found in section II.A.4 of the Addendum of this final rule.

[[Page 61338]]

\8\ This column shows the estimated change in payments from FY 2026 to FY 2027.

32. On pages 50419 through 50420, the table titled ``Table II.--
Impact Analysis Of Changes On Average Payments Per Discharge For
Operating Costs And Uncompensated Care'' is corrected to read as
follows:

Table II--Impact Analysis of Changes on Average Payments Per Discharge for Operating Costs and Uncompensated
Care
----------------------------------------------------------------------------------------------------------------
Estimated Estimated
average FY average FY
Number of 2026 2027 FY 2027
hospitals payment payment changes
per per
discharge discharge
(1) (2) (3) (4)
----------------------------------------------------------------------------------------------------------------
All Hospitals................................................... 3,006 18,992 19,318 1.7
By Geographic Location:
Urban hospitals............................................. 2,358 19,469 19,811 1.8
Rural hospitals............................................. 648 13,490 13,637 1.1
Bed Size (Urban):
0-99 beds................................................... 640 13,825 13,846 0.1
100-199 beds................................................ 673 15,182 15,410 1.5
200-299 beds................................................ 400 17,002 17,278 1.6
300-499 beds................................................ 394 18,931 19,238 1.6
500 or more beds............................................ 249 24,833 25,361 2.1
Bed Size (Rural):
0-49 beds................................................... 309 11,569 11,607 0.3
50-99 beds.................................................. 174 12,829 12,888 0.5
100-149 beds................................................ 95 12,787 12,960 1.4
150-199 beds................................................ 41 14,516 14,726 1.4
200 or more beds............................................ 29 16,529 16,840 1.9
Urban by Region:
New England................................................. 102 20,665 21,048 1.9
Middle Atlantic............................................. 272 22,780 23,400 2.7
East North Central.......................................... 364 18,363 18,767 2.2
West North Central.......................................... 155 17,986 18,116 0.7
South Atlantic.............................................. 393 17,334 17,731 2.3
East South Central.......................................... 140 15,875 16,014 0.9
West South Central.......................................... 356 18,616 18,997 2.0
Mountain.................................................... 177 18,567 18,822 1.4
Pacific..................................................... 347 23,120 23,205 0.4
Rural by Region:
New England................................................. 19 18,019 18,300 1.6
Middle Atlantic............................................. 46 15,327 15,547 1.4
East North Central.......................................... 104 12,966 13,124 1.2
West North Central.......................................... 71 13,543 13,638 0.7
South Atlantic.............................................. 110 12,712 12,851 1.1
East South Central.......................................... 119 11,920 11,984 0.5
West South Central.......................................... 114 11,759 11,860 0.9
Mountain.................................................... 41 15,069 15,409 2.3
Pacific..................................................... 24 17,509 17,710 1.2
Puerto Rico
Puerto Rico Hospitals....................................... 52 15,440 15,358 -0.5
By Payment Classification:
Urban hospitals............................................. 1,526 16,848 17,094 1.5
Rural areas................................................. 1,480 20,375 20,753 1.9
Teaching Status:
Nonteaching................................................. 1,696 13,967 14,135 1.2
Fewer than 100 residents.................................... 1,004 16,799 17,061 1.6
100 or more residents....................................... 306 28,424 29,039 2.2
Urban DSH:
Non-DSH..................................................... 370 13,641 13,901 1.9
100 or more beds............................................ 829 17,833 18,084 1.4
Less than 100 beds.......................................... 327 13,244 13,389 1.1
Rural DSH:
Non-DSH..................................................... 130 16,157 16,273 0.7
SCH......................................................... 212 14,356 14,639 2.0
RRC......................................................... 922 21,174 21,582 1.9
100 or more beds............................................ 31 19,357 19,881 2.7
Less than 100 beds.......................................... 185 11,102 10,979 -1.1
Urban teaching and DSH:
Both teaching and DSH....................................... 482 19,443 19,765 1.7
Teaching and no DSH......................................... 68 15,058 15,309 1.7
No teaching and DSH......................................... 674 14,726 14,859 0.9
No teaching and no DSH...................................... 302 12,628 12,895 2.1
Special Hospital Types:
SCH......................................................... 419 15,951 16,260 1.9
MDH......................................................... 166 12,812 11,949 -6.7
Type of Ownership:
Voluntary................................................... 1,905 18,663 18,983 1.7
Proprietary................................................. 693 16,911 17,149 1.4
Government.................................................. 406 23,572 24,039 2.0

[[Page 61339]]

Medicare Utilization as a Percent of Inpatient Days:
0-25........................................................ 1,664 20,940 21,330 1.9
25-50....................................................... 1,266 16,762 17,013 1.5
50-65....................................................... 41 15,903 16,269 2.3
Over 65..................................................... 9 12,061 11,802 -2.1
Medicaid Utilization as a Percent of Inpatient Days:
0-25........................................................ 2,038 16,833 17,115 1.7
25-50....................................................... 860 22,874 23,282 1.8
50-65....................................................... 84 29,386 29,893 1.7
Over 65..................................................... 24 20,125 20,035 -0.4
FY 2027 Reclassifications:
All Reclassified Hospitals.................................. 1,104 19,972 20,346 1.9
Non-Reclassified Hospitals.................................. 1,902 17,729 17,993 1.5
Urban Hospitals Reclassified................................ 977 21,043 21,449 1.9
Urban Non-reclassified Hospitals............................ 1,399 16,832 17,064 1.4
Rural Hospitals Reclassified Full Year...................... 272 13,626 13,784 1.2
Rural Non-reclassified Hospitals Full Year.................. 358 13,296 13,460 1.2
All hospitals that reclassified from urban to rural in 884 21,317 21,725 1.9
accordance with section 1886(d)(8)(E) as implemented at 42
CFR 412.103................................................
Other Reclassified Hospitals (Section 1886(d)(8)(B), also 52 12,668 12,653 -0.1
known as Lugar hospitals)..................................
----------------------------------------------------------------------------------------------------------------

33. On pages 50424 through 50425, the table titled ``Modeled
Uncompensated Care Payments* And Supplemental Payments For Estimated FY
2027 DSHs By Hospital Type'' is corrected to read as follows:

Modeled Uncompensated Care Payments* and Supplemental Payments for Estimated FY 2027 DSHS by Hospital Type
----------------------------------------------------------------------------------------------------------------
FY 2026 FY 2027
estimated estimated Dollar
Number of uncompensated uncompensated Difference:
estimated care payments care payments FY 2026-FY Percent
DSHs and supplemental and supplemental 2027 ($ in change ***
payments ($ in payments ** ($ millions)
millions) in millions)
(1) (2) (3) (4) (5)
----------------------------------------------------------------------------------------------------------------
Total.................................. 2,274 7,821 8,049 228 2.9%
By Geographic Location
Urban Hospitals.................... 1,840 7,384 7,633 249 3.4
Other Urban Areas.................. 950 3,240 3,289 50 1.5
Large Urban Areas.................. 890 4,144 4,344 199 4.8
Rural Hospitals.................... 434 437 416 -21 -4.8
Bed Size (Urban)
0 to 99 Beds....................... 345 316 307 -9 -2.9
100 to 249 Beds.................... 744 1,578 1,605 26 1.7
250+ Beds.......................... 751 5,490 5,722 232 4.2
Bed Size (Rural)
0 to 99 Beds....................... 322 232 223 -9 -3.9
100 to 249 Beds.................... 102 165 153 -12 -7.4
250+ Beds.......................... 10 40 40 0 0.8
Urban by Region
New England........................ 82 203 210 7 3.4
Middle Atlantic.................... 213 867 935 68 7.9
South Atlantic..................... 290 738 723 -15 -2.0
East North Central................. 99 363 349 -15 -4.1
East South Central................. 301 1,896 1,931 35 1.8
West North Central................. 120 471 483 12 2.6
West South Central................. 244 1,729 1,838 109 6.3
Mountain........................... 142 348 376 28 8.2
Pacific............................ 305 670 689 19 2.8
Puerto Rico........................ 44 98 98 0 0.5
Rural by Region
New England........................ 7 11 9 -2 -21.0
Middle Atlantic.................... 34 25 26 2 6.1
South Atlantic..................... 65 55 52 -3 -5.8
East North Central................. 26 27 23 -4 -15.3
East South Central................. 82 124 120 -4 -3.0
West North Central................. 94 82 76 -6 -7.7
West South Central................. 99 92 89 -3 -2.9
Mountain........................... 19 13 13 -1 -4.5

[[Page 61340]]

Pacific............................ 8 7 8 1 7.3
By Payment Classification
Urban Hospitals.................... 1,130 3,180 3,299 119 3.7
Large Urban Areas.................. 605 1,926 2,018 93 4.8
Other Urban Areas.................. 525 1,255 1,281 26 2.1
Rural Hospitals.................... 1,144 4,641 4,749 109 2.3
Teaching Status
Nonteaching........................ 1,150 1,766 1,771 5 0.3
Fewer than 100 residents........... 825 2,811 2,862 51 1.8
100 or more residents.............. 299 3,244 3,416 172 5.3
Type of Ownership
Voluntary.......................... 1,469 4,474 4,596 122 2.7
Proprietary........................ 453 1,070 1,053 -17 -1.6
Government......................... 352 2,276 2,400 123 5.4
Medicare Utilization Percent ****
0 to 25............................ 1,466 6,339 6,605 266 4.2
25 to 50........................... 794 1,477 1,440 -38 -2.5
50 to 65........................... 13 5 4 -1 -13.4
Greater than 65.................... 1 ................ ................ 0 0.0
Medicaid Utilization Percent ****
0 to 25............................ 1,358 3,646 3,674 29 0.8
25 to 50........................... 805 3,464 3,619 155 4.5
50 to 65........................... 86 686 730 44 6.4
Greater than 65.................... 25 25 25 0 1.7
----------------------------------------------------------------------------------------------------------------
Source: Dobson [verbar] DaVanzo analysis of 2021, 2022 and 2023 Hospital Cost Reports.
* Dollar UCP calculated by [0.75 * estimated section 1886(d)(5)(F) payments * Factor 2 * Factor 3]. When summed
across all hospitals projected to receive DSH payments, UCP and supplemental payments are estimated to be
$7.821 million in FY 2026, and UCP and supplemental payments are estimated to be $8.049 million in FY 2027.
** For IHS/Tribal hospitals and Puerto Rico hospitals, this impact table reflects the supplemental payments.
*** Percentage change is determined as the difference between Medicare UCP and supplemental payments modeled for
this FY 2027 IPPS/LTCH PPS final rule (column 3) and Medicare UCP and supplemental payments modeled for the FY
2026 IPPS/LTCH PPS final rule (column 2) divided by Medicare UCP and supplemental payments modeled for the FY
2026 IPPS/LTCH PPS final rule (column 2) times 100 percent.
**** Hospitals with missing or unknown Medicare utilization or Medicaid utilization are not shown in the table.

34. On page 50425,
a. Second column, first full paragraph, line 5, the figure ``4.6''
is corrected to read ``4.8''.
b. Third column, first full paragraph:
(1) Line 4, the figure ``-3.7'' is corrected to read ``-3.9''.
(2) Line 5,
(a) The figure ``-7.2'' is corrected to read ``-7.4''.
(b) The figure ``1.0'' is corrected to read ``0.8''.
(3) Line 7, the phrase ``hospitals, those with 250+ beds and 100-
249 beds, are projected to receive an above average increase in
payments of 4.1.'' is corrected to read ``hospitals (those with 250+
beds) are projected to receive an above average increase in payments of
4.2.''.
(4) Line 13, the figure ``1.9'' is corrected to read ``1.7''.
(5) Line 14, the figure ``-2.2'' is corrected to read ``-3.0''.
35. On page 50426, first column,
a. First full paragraph:
(1) Line 7, the figure ``4.9'' is corrected to read ``4.8''.
(2) Line 10, the figure ``1.8'' is corrected to read ``2.1''.
b. Second full paragraph:
(1) Line 4:
(a) The figure ``0.5'' is corrected to read ``0.3''.
(b) The figure ``1.8'' is corrected to read ``1.8''.
((2) Line 10, the figure ``2.9'' is corrected to read ``2.7''
(3) Line 11, the figure ``-1.3'' is corrected to read ``-1.6''.
(4) Line 14, the figure ``5.0'' is corrected to read ``5.4''.
c. Third full paragraph:
(1) Line 4, the figure ``4.3'' is corrected to read ``4.2''.
(2) Line 7:
(a) The figure ``2.9'' is corrected to read ``2.5''.
(b) The figure ``13.2'' is corrected to read ``13.4''.
(3) Line 20, the figure ``6.0'' is corrected to read ``6.4''.
(4) Line 25, the figure ``0.8'' is corrected to read ``0.8''.
(5) Line 26, the figure ``1.9'' is corrected to read ``1.7''.
36. On page 50446, third column,
a. Second bulleted paragraph, line 4, the figure ``0.9901'' is
corrected to read ``0.9899''.
b. Third paragraph, line 6, the figure ``3,005'' is corrected to
read ``3,006''.
c. Fourth paragraph, line 3, the figure ``3.0 percent'' is
corrected to read ``2.9 percent''.
d. Last paragraph, line 2, the figure ``3.0 percent'' is corrected
to read ``2.9 percent''.
37. On page 50447:
a. First column, line 4, the figure ``3.0 percent'' is corrected to
read ``2.9 percent''.
b. Third column, line 9, the figure ``3.2 percent'' is corrected to
read ``3.1 percent''.
c. Third column, last line in the paragraph, the figure ``3.0
percent'' is corrected to read ``3.2 percent''.
38. On pages 50448 through 50449, the table titled ``Table III--
Comparison of Total Payments per Case'' is corrected to read as
follows:

[[Page 61341]]

Table III--Comparison of Total Payments per Case
----------------------------------------------------------------------------------------------------------------
Average FY Average FY
Number of 2026 2027
FY 2026 Payments compared to FY 2027 payments hospitals payments/ payments/ Change
case case
----------------------------------------------------------------------------------------------------------------
All Hospitals................................................... 3,006 1,241 1,277 2.9
By Geographic Location:
Urban hospitals............................................. 2,358 1,275 1,312 2.9
Rural hospitals............................................. 648 848 874 3.1
Bed Size (Urban):
0-99 beds................................................... 640 965 977 1.2
100-199 beds................................................ 673 1,062 1,094 3.0
200-299 beds................................................ 400 1,155 1,189 2.9
300-499 beds................................................ 394 1,264 1,302 3.0
500 or more beds............................................ 249 1,529 1,575 3.0
Bed Size (Rural):
0-49 beds................................................... 309 705 722 2.4
50-99 beds.................................................. 174 812 835 2.8
100-149 beds................................................ 95 824 849 3.0
150-199 beds................................................ 41 909 936 3.0
200 or more beds............................................ 29 1,033 1,069 3.5
Urban by Region:
New England................................................. 102 1,364 1,410 3.4
Middle Atlantic............................................. 272 1,445 1,496 3.5
East North Central.......................................... 364 1,179 1,228 4.2
West North Central.......................................... 155 1,210 1,236 2.1
South Atlantic.............................................. 393 1,133 1,175 3.7
East South Central.......................................... 140 1,036 1,056 1.9
West South Central.......................................... 356 1,175 1,199 2.0
Mountain.................................................... 177 1,267 1,294 2.1
Pacific..................................................... 347 1,591 1,618 1.7
Rural by Region:
New England................................................. 19 1,097 1,150 4.8
Middle Atlantic............................................. 46 991 1,022 3.1
East North Central.......................................... 104 837 871 4.1
West North Central.......................................... 71 863 876 1.5
South Atlantic.............................................. 110 763 797 4.5
East South Central.......................................... 119 757 769 1.6
West South Central.......................................... 114 754 774 2.7
Mountain.................................................... 41 922 933 1.2
Pacific..................................................... 24 1,067 1,097 2.8
Puerto Rico:
Puerto Rico Hospitals....................................... 52 611 603 -1.3
By Payment Classification:
Urban hospitals............................................. 1,526 1,158 1,187 2.5
Rural areas................................................. 1,480 1,295 1,336 3.2
Teaching Status:
Nonteaching................................................. 1,696 1,004 1,029 2.5
Fewer than 100 residents.................................... 1,004 1,150 1,186 3.1
100 or more residents....................................... 306 1,665 1,715 3.0
Urban DSH:
Non-DSH..................................................... 370 1,058 1,081 2.2
100 or more beds............................................ 829 1,203 1,234 2.6
Less than 100 beds.......................................... 327 870 890 2.3
Rural DSH:
Non-DSH..................................................... 130 1,135 1,172 3.3
SCH......................................................... 212 874 900 3.0
RRC......................................................... 922 1,340 1,382 3.1
100 or more beds............................................ 31 1,195 1,244 4.1
Less than 100 beds.......................................... 185 697 718 3.0
Urban teaching and DSH:
Both teaching and DSH....................................... 482 1,259 1,293 2.7
Teaching and no DSH......................................... 68 1,106 1,143 3.3
No teaching and DSH......................................... 674 1,063 1,088 2.4
No teaching and no DSH...................................... 302 1,023 1,037 1.4
Special Hospital Types:
SCH......................................................... 419 993 1,025 3.2
MDH......................................................... 166 786 812 3.3
Type of Ownership:
Voluntary................................................... 1,905 1,238 1,277 3.2
Proprietary................................................. 693 1,159 1,185 2.2
Government.................................................. 406 1,355 1,391 2.7
Medicare Utilization as a Percent of Inpatient Days:
0-25........................................................ 1,664 1,290 1,327 2.9

[[Page 61342]]

25-50....................................................... 1,266 1,186 1,221 3.0
50-65....................................................... 41 1,146 1,191 3.9
Over 65..................................................... 9 844 880 4.3
Medicaid Utilization as a Percent of Inpatient Days:
0-25........................................................ 2,038 1,146 1,180 3.0
25-50....................................................... 860 1,419 1,459 2.8
50-65....................................................... 84 1,567 1,587 1.3
Over 65..................................................... 24 1,345 1,360 1.1
FY 2027 Reclassifications:
All Reclassified Hospitals.................................. 1,104 1,287 1,328 3.2
Non-Reclassified Hospitals.................................. 1,902 1,182 1,212 2.5
Urban Hospitals Reclassified................................ 977 1,345 1,387 3.1
Urban Non-Reclassified Hospitals............................ 1,399 1,157 1,185 2.4
Rural Hospitals Reclassified Full Year...................... 272 863 889 3.0
Rural Non-Reclassified Hospitals Full Year.................. 358 822 848 3.2
All Section 401 Rural Reclassified Hospitals................ 884 1,357 1,400 3.2
Other Reclassified Hospitals (Section 1886(d)(8)(B))........ 52 869 896 3.1
----------------------------------------------------------------------------------------------------------------

39. On page 50449, bottom half of page,
a. Second column, last bulleted partial paragraph, line 4, the
figure ``$52,132.76'' is corrected to read ``$52,126.94''.
b. Third column, first partial paragraph,
(1) Line 2, the figure ``1.002679'' is corrected to read
``1.0025669'',
(2) Line 6, the figure ``$51,113.55'' is corrected to read
``$51,107.84''.
40. On page 50451, the table titled ``Table IV: Impact of Payment
Rate and Policy Changes to LTCH PPS Payments for LTCH PPS Standard
Federal Payment Rate Cases for FY 2027 (Estimated FY 2026 Payments
Compared to Estimated FY 2027 Payments)'' is corrected to read as
follows:

Table IV--Impact of Payment Rate and Policy Changes to LTCH PPS Payments for LTCH PPS Standard Federal Payment Rate Cases for FY 2027
[Estimated FY 2026 Payments Compared to Estimated FY 2027 Payments]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Percent change Percent change
Average FY Average FY due to the due to changes Percent change
Number of LTCH 2026 LTCH PPS 2027 LTCH PPS annual update to area wage due to all
LTCH classification Number of PPS standard payment per payment per to the adjustment standard
LTCHS payment rate standard standard standard with wage payment rate
cases payment rate payment rate federal rate budget changes \4\
\1\ \2\ neutrality \3\
(1) (2) (3) (4) (5) (6) (7) (8)
--------------------------------------------------------------------------------------------------------------------------------------------------------
ALL PROVIDERS........................... 319 41,580 58,586 59,881 2.2 0.0 2.2
BY LOCATION:
RURAL............................... 16 1,032 47,271 48,059 2.2 -0.3 1.7
URBAN............................... 303 40,548 58,874 60,182 2.2 0.0 2.2
BY OWNERSHIP TYPE:
VOLUNTARY........................... 53 4,933 59,132 60,203 2.2 -0.3 1.8
PROPRIETARY......................... 257 36,119 58,266 59,569 2.2 0.0 2.2
GOVERNMENT.......................... 9 528 75,399 78,223 2.2 1.1 3.7
BY REGION:
NEW ENGLAND......................... 9 1,299 49,082 50,212 2.2 0.7 2.3
MIDDLE ATLANTIC..................... 20 3,003 69,794 72,151 2.2 1.1 3.4
SOUTH ATLANTIC...................... 60 9,293 57,085 58,207 2.2 -0.3 2.0
EAST NORTH CENTRAL.................. 46 5,059 61,409 62,481 2.2 -0.4 1.7
EAST SOUTH CENTRAL.................. 32 3,107 51,875 52,569 2.2 -0.8 1.3
WEST NORTH CENTRAL.................. 22 2,124 53,603 54,802 2.2 0.2 2.2
WEST SOUTH CENTRAL.................. 82 9,524 51,091 51,974 2.2 -0.2 1.7
MOUNTAIN............................ 25 2,227 57,878 59,442 2.2 0.0 2.7
PACIFIC............................. 23 5,944 72,508 74,668 2.2 0.6 3.0
BY BED SIZE:

[[Page 61343]]

BEDS: 0-24.......................... 34 2,019 60,063 61,556 2.2 0.2 2.5
BEDS: 25-49......................... 151 15,578 52,674 53,655 2.2 -0.2 1.9
BEDS: 50-74......................... 75 10,580 60,072 61,439 2.2 0.0 2.3
BEDS: 75-124........................ 41 8,349 66,152 67,802 2.2 0.1 2.5
BEDS: 125+.......................... 18 5,054 60,611 62,055 2.2 0.3 2.4
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Estimated FY 2027 LTCH PPS payments for LTCH PPS standard Federal payment rate criteria based on the payment rate and factor changes applicable to
such cases presented in the preamble of and the Addendum to this final rule.
\2\ Percent change in estimated payments per discharge for LTCH PPS standard Federal payment rate cases from FY 2026 to FY 2027 due to the annual update
to the LTCH PPS standard Federal payment rate.
\3\ Percent change in estimated payments per discharge for LTCH PPS standard Federal payment rate cases from FY 2026 to FY 2027 due to the changes to
the area wage level adjustment under Sec. 412.525(c) (that is, the updated hospital wage data and the labor-related share) with budget neutrality.
\4\ Percent change in estimated payments per discharge for LTCH PPS standard Federal payment rate cases from FY 2026 (shown in Column 4) to FY 2027
(shown in Column 5), due to all of the changes to the rates and factors applicable to such cases presented in the preamble and the Addendum to this
final rule.

41. On page 50457,
a. The table titled ``Table X: Estimated Impact On Small
Businesses*'' is corrected to read as follows:

Table X--Estimated Impact on Small Businesses *
----------------------------------------------------------------------------------------------------------------
Estimated Estimated
Total Estimated Total impact impact to average impact
facilities small ($1 million) small per small
businesses businesses business
----------------------------------------------------------------------------------------------------------------
IPPS Hospitals.................. 3,006 1,386 $2,900 $52,200,000 $37,662
LTCHs........................... 319 147 54 1,000,000 6,803
----------------------------------------------------------------------------------------------------------------
* Based on the assumptions that small firms represent 46.1 percent of affected entities and account for
approximately 1.8 percent of total industry revenues using the SBA size standards.

b. Bottom half of page, second column, first full paragraph:
(1) Line 2, the figure ``3,005'' is corrected to read ``3,006'',
(2) Line 15, the figure ``6.8'' is corrected to read ``6.7''.
42. On page 50458, first column, first full paragraph, line 14, the
figure ``3,005'' is corrected to read ``3,006''.

Liesl I. Fowler,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2026-19946 Filed 9-28-26; 8:45 am]
BILLING CODE 4169-69-P

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