Medicare Payment Rules
IHA provides summaries and context on annual proposed and final changes to Medicare payment policies. See Medicare Advocacy for IHA comment letters on proposed rules.
CY 2025 PFS
Summary of telehealth, behavioral health, and health equity policies finalized in the CY 2025 Medicare Physician Fee Schedule final rule.
CY 2025 Medicare HH final rule brief
On Nov. 1, CMS posted the calendar fiscal year 2025 Medicare Home Health Prospective Payment System (HH PPS) final rule effective Jan. 1, 2025 through Dec. 31, 2025.
CY 2025 Medicare OPPS final rule brief
On Nov. 1, CMS posted the calendar fiscal year 2025 Medicare Outpatient Prospective Payment System (OPPS) final rule effective Jan. 1, 2025 through Dec. 31, 2025.
FY 2025 Medicare LTCH final rule brief
On August 1, CMS posted the federal fiscal year 2025 Medicare Long-Term Care Hospital (LTCH) Prospective Payment System final rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare IPF final rule brief
On July 31, CMS posted the federal fiscal year 2025 Medicare Inpatient Psychiatric Facility (IPF) Prospective Payment System final rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare IPPS final rule brief
On August 1, CMS posted the federal fiscal year 2025 Medicare Inpatient Prospective Payment System (IPPS) final rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare SNF final rule brief
On July 31, CMS posted the federal fiscal year 2025 Medicare Skilled Nursing Facility (SNF) Prospective Payment System final rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare IRF final rule brief
On July 31, CMS posted the federal fiscal year 2025 Medicare Inpatient Rehabilitation Facility (IRF) Prospective Payment System final rule effective Oct. 1, 2024 through Sept. 30, 2025.
CY 2025 Medicare OPPS proposed rule brief
On July 22, CMS posted the calendar year 2025 Medicare Outpatient Prospective Payment System (OPPS) proposed rule effective Jan. 1, 2025 through Dec. 31, 2025.
CY 2025 Medicare HH proposed rule brief
On June 26, CMS posted the calendar year 2025 Medicare Home Health Prospective Payment System (HH PPS) proposed rule effective Jan. 1, 2025 through Dec. 31, 2025.
FY 2025 Medicare IPF proposed rule brief
On March 28, CMS posted the federal fiscal year 2025 Medicare Inpatient Psychiatric Facility (IPF) Prospective Payment System proposed rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare LTCH Proposed Rule Brief
On April 10, CMS posted the federal fiscal year 2025 Medicare Long-Term Care Hospital (LTCH) Prospective Payment System proposed rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 IPPS Proposed Rule
CMS released its annual proposed rule updating the Medicare Inpatient Prospective Payment System effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare SNF Proposed Rule Brief
On March 28, CMS posted the federal fiscal year 2025 Medicare Skilled Nursing Facility (SNF) Prospective Payment System proposed rule effective Oct. 1, 2024 through Sept. 30, 2025.
FY 2025 Medicare IRF Proposed Rule Brief
On March 27, CMS posted the federal fiscal year 2025 Medicare Inpatient Rehabilitation Facility (IRF) Prospective Payment System proposed rule effective Oct. 1, 2024 through Sept. 30, 2025.
CY 2024 Medicare PFS Final Rule (CMS-1784-F)
On Nov. 2, the Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY)
2024 physician fee schedule (PFS) final rule.
FY24 Medicare IPPS Final Rule (CMS-1785-F)
On Aug. 1, CMS posted the fiscal year 2024 (FY24) Medicare Inpatient Prospective Payment System (IPPS) final rule effective Oct. 1, 2023 through Sept. 30, 2024.
Proposed Changes to Hospital Price Transparency Requirements
CMS proposed several changes to hospital price transparency requirements in the CY24 OPPS proposed rule.
Proposed 340B Payment Remedy
Details on CMS’ proposed payment remedy in response to its unlawful 340B payment policy implemented in CY 2018.
FY 2024 IPPS Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
FY 2024 IRF PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient rehabilitation facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
FY 2024 IPF PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient psychiatric facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
FY 2024 SNF PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare skilled nursing facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
CY 2023 OPPS Final Rule
CMS finalized outpatient prospective payment system updates, effective Jan. 1, 2023 through Dec. 31, 2023.
Rural Emergency Hospitals – CoPs
CMS finalized Medicare Conditions of Participation for rural emergency hospitals, effective Jan. 1, 2023.
Rural Emergency Hospitals
CMS finalized policies and procedures specific to rural emergency hospitals, effective Jan. 1, 2023.
Update on 340B Drug Pricing Program
CMS restored the 340B reimbursement to average sales price plus 6% for calendar year 2023.
CY 2023 HH PPS Final Rule
CMS published the home health prospective payment system final rule effective Jan. 1, 2023 through Dec. 31, 2023.
FY 2023 IPPS Final Rule
CMS published the inpatient prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
FY 2023 LTCH Final Rule
CMS published the long term care hospital prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
FY 2023 SNF Final Rule
CMS published the skilled nursing facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
FY 2023 IRF Final Rule
CMS published the inpatient rehabilitation facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
FY 2023 Hospice Finale Rule
CMS published the Medicare hospice payment final rule effective Oct. 1, 2022 through Sept. 31, 2023.
FY 2023 IPF Final Rule
CMS published the inpatient psychiatric facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CY 2023 OPPS Proposed Rule
CMS published its annual proposed rule updating the Medicare outpatient prospective payment system effective Jan. 1, 2023 through Dec. 31, 2023.
CY 2023 HH Proposed Rule
CMS published its annual proposed rule updating the Medicare Home Health prospective payment system effective Jan. 1, 2023 through Dec. 31, 2023.
FFY 2023 PR LTCH
CMS published its annual proposed rule updating the Medicare Long-Term Care Hospital prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
FFY 2023 SNF Proposed Rule
CMS published its annual proposed rule updating the Medicare Skilled Nursing Facility Prospective Payment System, effective Oct. 1, 2022 through Sept. 30, 2023.
FFY 2023 IPPS Proposed Rule
CMS published its annual proposed rule update the Medicare Inpatient Prospective Payment System, effective Oct. 1, 2022 through Sept. 30, 2023.
FFY 2023 Hospice Proposed Rule
CMS published its annual proposed rule updating the Medicare Hospice payment system effective Oct. 1, 2022 through Sept. 30, 2023.
FFY 2023 IPF PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare Inpatient Psychiatric Facility prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
FFY 2023 IRF PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare Inpatient Rehabilitation Facility prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
CY 2022 OPPS Final Rule
CMS published its annual final rule updating the Medicare outpatient prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022. See IHA's fact sheet on the final rule.
CY 2022 Home Health PPS Final Rule
CMS published its annual final rule updating the Medicare home health prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022.
FFY 2022 Hospice PPS Final Rule
CMS published its annual final rule updating the Medicare Hospice prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 Long Term Care Hospital Final Rule Fact Sheet
CMS published its annual final rule updating the Medicare Long Term Care Hospital (LTCH) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 IPPS Final Rule
CMS published its federal fiscal year 2022 final rule updating the Medicare inpatient prospective payment system. Additional rulemaking is forthcoming.
FFY 2022 IPF PPS Final Rule
CMS published its federal fiscal year 2022 final rule updating the Medicare inpatient psychiatric facility PPS, including required reporting of COVID-19 healthcare personnel vaccination rates.
FFY 2022 IRF PPS Final Rule
CMS published its FFY 2022 final rule updating the Medicare inpatient rehabilitation facility prospective payment system including required reporting of COVID healthcare personnel vaccination rates.
FFY 2022 SNF PPS Final Rule
CMS published its federal FY 2022 final rule updating the Medicare skilled nursing facility prospective payment system, including required reporting of COVID healthcare personnel vaccination rates.
CY 2022 OPPS Proposed Rule
CMS published its calendar year 2022 proposed rule updating the Medicare outpatient prospective payment system, including updates to the hospital price transparency rule.
CY 2022 HH PPS Proposed Rule
CMS published its annual proposed rule updating the Medicare home health prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022.
FFY 2022 LTCH Proposed Rule
CMS published its annual proposed rule updating the Medicare long-term acute care hospital prospective payment system effective Oct. 1, 2021 through September 30, 2022.
FFY 2022 IPPS Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 Hospice Proposed Rule
CMS published its annual proposed rule updating the Medicare hospice prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 SNF Proposed Rule
CMS published its annual proposed rule updating the Medicare skilled nursing facility (SNF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 IPF Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient psychiatric facility (IPF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
FFY 2022 IRF Proposed Rule
CMS published its annual proposed rule updating the Medicare inpatient rehabilitation facility (IRF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS to Reprocess 2019 Excepted Off-Campus PBD Claims
CMS will begin reprocessing and recouping reimbursement made for certain 2019 outpatient services provided at excepted off-campus Provider-Based Departments.
CY 2021 OPPS Final Rule Fact Sheet
CMS published its annual final rule updating the Outpatient Prospective Payment System, effective Jan. 1, 2021. The final rule includes new COVID-19 hospital reporting requirements.
CY 2021 Final Rule Medicare Physician Fee Schedule Fact Sheet
CMS published its annual final rule updating the Medicare Physician Fee Schedule, effective Jan. 1, 2021, including changes to Medicare telehealth policy.
CY 2021 Final Rule Medicare Home Health Fact Sheet
CMS published its annual final rule updating the Medicare Home Health Prospective Payment System, effective Jan. 1, 2021 to Dec. 31, 2021.
FFY 2021 Final Rule Medicare Hospice Fact Sheet
CMS published its annual final rule updating the Medicare Hospice Prospective Payment System wage index, payment rates and quality-reporting program effective Oct. 1, 2020-Sept. 30, 2021.FFY 2021 Medicare LTCH Final Rule
On Sept. 3, CMS published its annual final rule updating the LTCH Prospective Payment System effective Oct. 1, 2020 through Sept. 30, 2021.
FFY 2021 Medicare IPPS Final Rule
On Sept. 3, CMS published its annual final rule updating the Inpatient Prospective Payment System effective Oct. 1, 2020 through Sept. 30, 2021.
FFY 2021 IPF Final Rule
CMS published its annual final rule updating the Medicare inpatient psychiatric facility prospective payment system effective Oct. 1, 2021. See IHA’s fact sheet for important details on the rule.
FFY 2021 IRF Final Rule
CMS published its annual final rule updating the Medicare inpatient rehabilitation facility prospective payment system effective Oct. 1, 2021. See IHA's fact sheet for important details on the rule.
FFY 2021 SNF Final Rule
CMS published its annual final rule updating the Medicare skilled nursing facility prospective payment system effective Oct. 1, 2021. IHA's fact sheet provides detailed information on the rule.
Final Rule: CY 2020 OPPS/ASC Services with Correction Notice
On Nov.12, CMS published the final annual update regarding the Medicare outpatient prospective payment system (OPPS) and ambulatory surgical center payment system (ASC) for calendar year (CY) 2020.