FY23 Final Rules for Hospice Providers, IPFs, IRFs

The ultimate guidelines for fiscal 12 months 2023 embrace a 3.8 % cost enhance for hospice suppliers, 2.5 % enhance for inpatient psychiatric services, and three.2 % enhance for inpatient rehabilitation services.

CMS has launched last guidelines solidifying Medicare reimbursement charges for hospice suppliers, inpatient psychiatric services (IPFs), and inpatient rehabilitation services (IRFs) for fiscal 12 months 2023.

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All three last guidelines included cost will increase and everlasting 5 % caps on wage index decreases to mitigate instability in IRF, IPF, and hospice funds.


The finalized FY 2023 hospice cost charge replace features a 3.8 %, or $825 million, enhance in hospice funds. This displays a 4.1 % market basket replace and a 0.3 share level lower for productiveness adjustment.

Hospices that don’t meet high quality reporting necessities will obtain a 2.0 share level discount to the annual cost replace enhance for 2023.

The rule additionally finalized an annual cost cap per affected person of $32,486.92.

CMS supplied an replace on the Hospice Outcomes and Affected person Analysis (HOPE) evaluation instrument within the last rule. The company included info on beta testing, derivatives, and extra outreach efforts deliberate for after beta testing through the adoption course of.

The rule additionally included potential future high quality measures for the Hospice High quality Reporting Program (HQRP) based mostly on HOPE knowledge.

As well as, CMS shared an replace on the Shopper Evaluation of Healthcare Suppliers and Methods (CAHPS) Hospice Survey and the experiment that examined the influence of including a web-based mannequin to the survey.


The FY 2023 IPF PPS last rule solidified a 2.5 % enhance in IPF funds, equaling $90 million. The cost replace displays a 4.1 % market basket replace, a 0.3 % discount for productiveness, and a 1.2 share level lower in outlier funds.

After requesting feedback on the IPF PPS refinement evaluation outcomes, CMS said that it obtained suggestions from MedPAC, particular person IPF hospitals and well being programs, and supplier and affected person advocacy organizations. The company plans to make use of these feedback to tell future rulemaking.

CMS additionally obtained feedback on addressing healthcare disparities and advancing well being fairness via high quality reporting, which it plans to contemplate when growing future insurance policies. The company didn’t make any adjustments to the IPF High quality Reporting Program within the last rule.


The FY 2023 IRF PPS last rule included a 3.2 %, or $275 million, enhance in IRF funds. The rise displays a 4.2 % market basket replace, a 0.3 % lower for productiveness, and a 0.6 share level discount in outlier funds.

The IRF PPS proposed rule included a 3.2 % market basket replace, a productiveness reduce of 0.4 share factors, and a 0.8 % lower in outlier funds. These updates obtained pushback from the American Hospital Affiliation (AHA).

In a June 2022 letter to CMS, AHA said that the proposed 2.0 % cost enhance didn’t precisely mirror the monetary challenges hospitals have been dealing with, reminiscent of substantial labor bills.

Within the last rule, CMS codified the IRF educating standing adjustment coverage, which adjusts funds to mirror the upper prices of educating IRFs.

The rule additionally finalized adjustments to the IRF High quality Reporting Program.

IRFs that don’t meet reporting necessities will obtain a 2.0 share level discount of their annual enhance elements.

CMS finalized its proposal to require IRFs to gather high quality knowledge on all sufferers, no matter payer. In accordance with the company, gathering knowledge on all IRF sufferers will provide a whole view of the standard of care supplied by IRFs and guarantee all sufferers are receiving the identical high quality of care.

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