Prospective Payment System (PPS) Inpatient Psych

Section 124(c) of Pub. L. 106-113, the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), directs the implementation of a per diem Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS).

The IPF PPS must include an "adequate patient classification system" that reflects differences in patient resource use and costs. The Centers for Medicare & Medicaid Services (CMS) is proposing an IPF PPS that uses available administrative data to develop various adjustments to a federal per diem base amount. The adjustments were derived using regression analysis to determine which factors are relevant to predicting patient resources. These payment adjusters include both facility-specific as well as patient-specific adjustments.

WHA Contact

Brian Potter
Senior Vice President, Finance/Chief Operating Officer
EMAIL: Brian Potter