Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update; Correction

Issuing agencies

Abstract

This document corrects technical errors in the final action that appeared in the July 31, 2026 Federal Register titled "Medicare Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment System--Rate Update".

Full Text

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<title>Federal Register, Volume 91 Issue 189 (Thursday, October 1, 2026)</title>
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[Federal Register Volume 91, Number 189 (Thursday, October 1, 2026)]
[Rules and Regulations]
[Pages 62323-62327]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-20134]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 412

[CMS-1847-CN]
RIN 0938-AV77


Medicare Program; FY 2027 Inpatient Psychiatric Facilities 
Prospective Payment System--Rate Update; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final rule; correction.

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SUMMARY: This document corrects technical errors in the final action 
that appeared in the July 31, 2026 Federal Register titled ``Medicare 
Program; FY 2027 Inpatient Psychiatric Facilities Prospective Payment 
System--Rate Update''.

DATES: This correction is effective October 1, 2026.

FOR FURTHER INFORMATION CONTACT: 
    The IPF Payment Policy mailbox at <a href="/cdn-cgi/l/email-protection#ade4fdebfdccd4c0c8c3d9fdc2c1c4ced4edcec0de83c5c5de83cac2db"><span class="__cf_email__" data-cfemail="4f061f091f2e36222a213b1f2023262c360f2c223c6127273c61282039">[email&#160;protected]</span></a> for 
information regarding the IPF wage index.
    Nick Brock (410) 786-5148, for general information regarding the 
inpatient psychiatric facilities prospective payment system (IPF PPS).
    Kaleigh Emerson, <a href="/cdn-cgi/l/email-protection#b7dcd6dbd2ded0df99d2dad2c5c4d8d986f7d4dac499dfdfc499d0d8c1"><span class="__cf_email__" data-cfemail="640f0508010d030c4a01090116170b0a55240709174a0c0c174a030b12">[email&#160;protected]</span></a>, for information 
regarding the IPF Quality Reporting Program.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2026-15588 of July 31, 2026, the fiscal year (FY) 2027 
Inpatient Psychiatric Facilities Prospective Payment System--Rate 
Update final rule (FY 2027 IPF PPS final rule) (91 FR 48514), there 
were a number of technical errors that are identified and corrected in 
this correcting document.

II. Summary of Errors

A. Summary of Errors in the Preamble

    There was a technical error in the calculation of the final FY 2027 
IPF PPS wage indexes, which impacted several calculations. There is an 
impact to the wage index for one provider in Core-Based Statistical 
Area (CBSA) 25620 for Hattiesburg, Mississippi due to the recalculated 
wage indexes, and thus we recalculated the impact analysis provided in 
Table 16 of the FY 2027 IPF PPS final rule (91 FR 48579 through 48580). 
Therefore, changes are needed to the published values in Table 16. We 
also recalculated the wage index budget neutrality factor; it changed 
from 0.9989 to 0.9986. This recalculated wage index budget neutrality 
factor affected the FY 2027 IPF PPS rates.
    On pages 48514 and 48521, The IPF PPS Federal per diem base rate 
changed from $912.40 to $912.13. The IPF PPS Federal per diem base rate 
for providers who failed to report quality data changed from $894.56 to 
$894.29. The electroconvulsive therapy (ECT) payment per treatment 
changed from $688.59 to $688.38. The ECT payment per treatment for 
providers who failed to report quality data changed from $675.13 to 
$674.93.
    On pages 48514, 48521, and 48527, the wage index budget neutrality 
factor changed from 0.9989 to 0.9986.
    On page 48523, we inadvertently made a typographical error 
regarding the number of ICD-10-CM diagnosis codes added to the 
Poisoning comorbidity code list.
    On page 48529, we inadvertently made a typographical error 
regarding the adjustment factor for IPFs that do not have a qualifying 
emergency department (ED).
    On page 48570, we inadvertently omitted a footnote.
    On pages 48579 and 48580, Table 16 reflects the impact to providers 
based on the inaccurate calculation of the FY 2027 IPF PPS wage index; 
therefore, Table 16 is updated to reflect the correct calculations.
    On page 48580, the largest payment percent decrease for IPF 
hospitals reflects the impact to providers based on the inaccurate 
calculation of the FY 2027 IPF PPS wage index; therefore, an update is 
needed to reflect the correct impact.

B. Summary of Errors and Corrections in the Tables Posted on the CMS 
Website for the IPF PPS Wage Index

    As discussed in the FY 2027 IPF PPS final rule (91 FR 48525), we 
used the concurrent pre-floor, pre-reclassified Inpatient Prospective 
Payment System (IPPS) hospital wage index as the basis for the IPF wage 
index. For FY 2027, the concurrent pre-floor, pre-reclassified IPPS 
hospital wage data are from cost reporting periods beginning on or 
after October 1, 2022 and before October 1, 2023 (FY 2023 cost report 
data), as discussed in the final rule 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'' 
(hereinafter referred to as the FY 2027 IPPS/LTCH PPS final rule) (91 
FR 49790).
    In calculating the wage index under the FY 2027 IPPS/LTCH PPS final 
rule, we made an inadvertent error related to the calculation of the 
wage index. This error is identified, discussed, and corrected in the 
correction notice 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; Correction'', published 
elsewhere in this issue of the Federal Register.
    Under our methodologies as finalized in the FY 2027 IPPS/LTCH PPS 
final rule, we exclude hospitals that have subsequently converted to 
rural emergency hospitals (REHs) from certain data and calculations 
used in the IPPS ratesetting. Specifically, we stated that we exclude 
REHs, including hospitals that subsequently became REHs after the 
period from which the data were taken for purposes of developing the 
Medicare Severity Diagnosis-Related Group (MS-DRG) relative weights for 
FY 2027 (91 FR 49672) and from the calculation of the average 
standardized amount (91 FR 50370). In addition, we stated that any 
hospital that is designated as a 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. This error affects the unadjusted, pre-reclassified, pre-
rural floor IPPS wage data and thereby affects the IPF PPS wage data 
for CBSA 25620 for Hattiesburg, Mississippi.
    We are correcting the wage index for CBSA 25620 for Hattiesburg, 
Mississippi in Table B setting forth the wage indexes for rural areas 
based on CBSA labor market areas and Table C setting forth the wage 
indexes for urban and rural areas without counties, which are available 
exclusively on the CMS website at <a href="https://www.cms.gov/medicare/medicare-fee-for-servicepayment/inpatientpsychfacilpps/wageindex">https://www.cms.gov/medicare/medicare-fee-for-servicepayment/inpatientpsychfacilpps/wageindex</a>.

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    The omitted wage data for the one hospital in CBSA 25620 required 
the recalculation of the final FY 2027 IPF PPS wage indexes. 
Additionally, as discussed in the FY 2027 IPF PPS final rule (91 FR 
48526 and 48527), changes to the wage index are made in a budget 
neutral manner so that updates do not increase expenditures. As 
discussed above, it was necessary to recalculate the FY 2027 IPF PPS 
wage index budget neutrality factor. The recalculated wage index budget 
neutrality factor changed from 0.9989 to 0.9986. This means that the 
IPF federal per diem base rate changed from $912.40 to $912.13 and the 
ECT payment per treatment changed from $688.59 to $688.38.

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.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects technical errors in the FY 2027 IPF PPS final rule and 
provides an updated IPF wage index resulting in revisions to the 
payment updates, payment impact, and related tables in the FY 2027 IPF 
PPS final rule. The corrections contained in this document are 
consistent with, and do not make substantive changes to, the policies 
and payment methodologies that were proposed, subject to notice and 
comment procedures, and adopted in the FY 2027 IPF PPS final rule. As a 
result, the corrections made through this document are intended to 
resolve inadvertent errors so that the FY 2027 IPF PPS final rule 
accurately reflects the policies adopted therein.
    In addition, even if this were a rulemaking to which the notice and 
comment 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 IPF 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 
comments on, and subsequently finalized. This final rule correction is 
intended solely to ensure that the FY 2027 IPF 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. 2026-15588 of July 31, 2026, (91 FR 48514), make the 
following corrections:
    1. On page 48514, third column,
    a. First second-level (++) bulleted paragraph, line 2, the figure 
``$912.40'' is corrected to read ``$912.13''.
    b. Second second-level (++) bulleted paragraph, line 3, the figure 
``$894.56'' is corrected to read ``$894.29''.
    c. Third second-level (++) bulleted paragraph, line 3, the figure 
``$688.59'' is corrected to read ``$688.38''.
    d. Fourth second-level (++) bulleted paragraph, line 3, the figure 
``$675.13'' is corrected to read ``$674.93''.
    e. Sixth second-level (++) bulleted paragraph, line 2, the figure 
``0.9989'' is corrected to read ``0.9986''.
    2. On page 48521,
    a. Second column, third full paragraph,
    (1) Line 12, the figure ``0.9989'' is corrected to read ``0.9986''.
    (2) Line 16, the figure ``$912.40'' is corrected to read 
``$912.13''.
    b. Third column,
    (1) First partial paragraph,
    (a) Line 1, the figure ``0.9989'' is corrected to read ``0.9986''.
    (b) Line 4, the figure ``$688.59'' is corrected to read 
``$688.38''.
    (2) First bulleted paragraph,
    (a) Line 13, the figure ``0.9989'' is corrected to read ``0.9986''.
    (b) Line 16, the figure ``$894.56'' is corrected to read 
``$894.29''.
    (3) Second bulleted paragraph,
    (a) Line 4, the figure ``0.9989'' is corrected to read ``0.9986''.
    (b) Line 8, the figure ``675.13'' is corrected to read ``674.93''.
    3. On page 48523, second column, third full paragraph, line 2, the 
figure ``10'' is corrected to read ``20''.
    4. On page 48527, first column, third full paragraph (``Step 3''), 
line 5, the figure ``0.9989'' is corrected to read ``0.9986''.
    5. On page 48529, middle of the page, second column, first full 
paragraph, line 12, the figure ``1.27'' is corrected to read ``1.28''.
    6. On page 48570, second column, first partial paragraph, lines 17 
and 18, the phrase ``to calculate an hourly pre-tax wage rate of 
$30.10/hr.'' is corrected to include footnote 41a to read as follows: 
``\41a\ <a href="https://www.bls.gov/news.release/pdf/wkyeng.pdf">https://www.bls.gov/news.release/pdf/wkyeng.pdf</a>. Accessed 
February 18, 2026.''
    7. On pages 48579 and 48580, TABLE 16: FY 2027 IPF PPS PAYMENT 
IMPACTS is corrected to read as follows:
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    8. On page 48580, bottom half of the page, third column, first 
partial paragraph,
    (1) Line 22, the figure ``1.1'' is corrected to read ``1.3''.
    (2) Line 23, the phrase ``with 25-49 beds'' is corrected to read 
``located in the East South Central region''.

Liesl I. Fowler,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2026-20134 Filed 9-30-26; 8:45 am]
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