Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule (CMS-1735-P)
On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2021. CMS has published this proposed rule to meet the legal requirement to update Medicare payment policies for IPPS hospitals on an annual basis. Due to the COVID-19 public health emergency response, CMS has waived the 60-day delay in the final rule effective date and replaced it with a 30-day delay in the effective date of the final rule. Proposed changes would apply to approximately 3,200 acute care hospitals for discharges occurring on or after October 1, 2020. Highlights include:
- A proposed increase in payment for IPPS hospitals that successfully participate in the Hospital Inpatient Quality Reporting (IQR) and demonstrate meaningful use of Electronic Health Record (EHR) program by approximately 3.1 percent.
- A test version of the of the ICD-10 MS-DRG Grouper Software Version 38, which includes new diagnosis and procedure codes; the draft version of the ICD-10 MS-DRG Definitions Manual Version 38; and the supplement diagnosis code mapping file from version 37 to version 38.
- A list of new, revised and deleted ICD-10-CM and ICD-10-PCS codes for FY 2021 identified by CMS. The proposed code list includes 72, 616 ICD-10-CM codes and 77,781 ICD-10-PCS codes.
The FY 2021 proposed rule is located in its entirety at the following link in PDF form and is 1,602 pages in length.
