On July 31, 2025, CMS released the FFY 2026 Inpatient Prospective Payment System Final Rule (CMS-1833-F).
- IPPS payments up 2.6% (3.3% market basket – 70 basis point productivity adjustment) for successful participants of Inpatient Quality Reporting and electronic health records
- LTC standard payment rate to be increased 2.7% (3.4% market basket – 70 basis point productivity adjustment)
- Uncompensated Care payments expected to increase $2.0BB
- Payments for inpatient stays involving new technology expected to rise $192MM
- Medicare Dependent Hospital additional payments and low-volume hospital payments set to expire September 30, 2025, unless again renewed by legislation as was done in the past
- National Labor Related Share established at 66% based on 2023-based IPPS market basket
- Low wage index policy discontinued due to loss in litigation
- Removing four quality measures and modifying four others
- Numerous updates to the Readmission Reduction and Hospital Value-Based Purchasing Programs
- TEAM (a five-year episode-based payment model running 5 years starting 1/1/2026 where five surgical procedures are the cost and quality of care responsibility of hospitals for the first 30 days after surgery) incurred changes to quality reporting, target price construction, and gave patients post-acute care choices by broadening the three-day SNF Rule waiver
Here is a link to the Fact Sheet from CMS that summarizes the Final Rule:
Here is a link to the Final Rule Homepage:
