September 8, 2020

CMS issues final inpatient payment rule for FY 2021

By: Judy Mathias

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) on September 2 issued its final inpatient prospective payment system (IPPS) rule, which will:

  • increase IPPS rates by 2.9% in FY 2021 for hospitals that report quality data and are meaningful users of electronic health records, resulting in an increase of about $3.5 billion.
  • require hospitals to report to CMS the median payer-specific rates for inpatient services negotiated with Medicare Advantage organizations, beginning in 2021.
  • create a new Medicare severity-diagnosis related group for Chimeric Antigen Receptor T-cell (CART-cell) therapy payment.
  • distribute $8.29 billion in disproportionate share hospital payments in FY 2021, a decrease of nearly $60.6 million.
  • provide add-on payments for 24 new technologies and expand the payments for certain antimicrobials approved under the Food and Drug Administration’s Limited Population Pathway for Antibacterial and Antifungal Drugs.

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