Affected Medicare Providers

10.3 - Affected Medicare Providers (Rev. 253, Issued: 12- 14-18, Effective: 01-16-19, Implementation: 01- 16-19) IPFs are certified under Medicare as inpatient psychiatric hospitals, which means, an institution that is primarily engaged in providing, by or under the supervision of a physician, psychiatric services for the diagnosis and treatment of mentally ill patients, maintains clinical records necessary to determine the degree and intensity of the treatment provided to the mentally ill patient, and meets staffing requirements sufficient to carry out active programs of treatment for individuals who are furnished care in the institution. A distinct part psychiatric unit may also be certified if it meets the clinical record and staffing requirements in 42 CFR 412.27. The regulations at 42 CFR 412.402 define an IPF as a hospital that meets the requirements specified in 42 CFR 412.22 and 42 CFR412.23(a), 42 CFR 482.60, 42 CFR 482.61, and 42 CFR 482.62, and a unit that meets the requirements specified in 42 CFR 412.22, 42 CFR 412.25, and 42 CFR 412.27. The IPF PPS does not change the basic criteria for a hospital or hospital unit to be classified as a psychiatric hospital or psychiatric unit that is excluded from the hospital prospective payment systems under §1886(d) and §1886(g) of the Act, nor does it revise the survey and certification procedures applicable to entities seeking this classification. The provider number ranges (Online Survey and Certification and Reporting System (OSCAR) number) for IPFs are from xx-4000 through xx-4499, xx-Sxxx, and xx-Mxxx. The following hospitals are not included in IPF PPS. • Veterans Administration hospitals; see 42 CFR 412.22 (c). • Hospitals that are reimbursed under state cost control systems approved under 42 CFR Part 403; Psychiatric hospitals (provider numbers xx-4000 - xx-4499) in the State of Maryland are paid under the IPF PPS. Psychiatric distinct part units located in an acute care hospital in Maryland identified by ‘S’ in the third position of the OSCAR number are waived from the IPF PPS, as are the acute hospital in which they are located. Currently there are no CAHs in Maryland. • Hospitals that are reimbursed in accordance with demonstration projects authorized under 42 CFR 402(a) of Pub.L. 90-248 (42 U. S. C. 1395b-1) or §222(a) of Pub.L. 92-603 (42 U. S. C. 1395b-1); IPFs in acute care hospitals that are paid in accordance with demonstration projects are paid in accordance with the demonstration project; • Nonparticipating hospitals furnishing emergency services to Medicare beneficiaries. See 42 CFR 412.22(c). Payments to foreign hospitals are made in accordance with the provisions set forth in 42 CFR 413.74.