in effect
This is a final rule from the Centers for Medicare & Medicaid Services (CMS) that sets the Medicare payment rates for inpatient psychiatric care for fiscal year 2026, running October 1, 2025 through September 30, 2026. It also adjusts how certain facility characteristics affect payment and modifies the quality data reporting requirements those facilities must meet.
The standard daily Medicare payment rate per patient rises from $876.53 to $892.87; facilities that did not submit required quality data receive a lower rate of $875.44 instead. The per-treatment payment for electroconvulsive therapy (ECT) increases from $661.52 to $673.85. The outlier threshold — the point at which Medicare pays extra for unusually costly cases — rises from $38,110 to $39,360. On the quality reporting side, four measures are dropped (health equity commitment, COVID-19 staff vaccination coverage, and two social-needs screening measures), the reporting period for an emergency-department-visit measure is adjusted, and the policy allowing facilities to request exceptions for extraordinary circumstances is formally written into regulation. In total, CMS estimates these changes will send roughly $70 million more to psychiatric facilities during FY 2026 and reduce facilities’ reporting compliance costs by about $1.75 million.
The rule directly affects Medicare-participating inpatient psychiatric facilities — both freestanding psychiatric hospitals and psychiatric units inside general acute care hospitals or critical access hospitals. Those facilities will receive the updated daily rates and ECT payments for every Medicare patient discharged during FY 2026, with facilities that skipped quality reporting receiving a smaller update. Medicare patients receiving covered inpatient psychiatric care at these facilities are indirectly affected, as the rule shapes which facilities remain financially viable and what quality data those facilities are required to track.