FY 2021 IPPS Proposed Rule Home Page

This is the home page for the FY 2021 Hospital Inpatient PPS proposed rule. The list below centralizes any IPPS file(s) related to the proposed rule. The list contains the proposed rule (display version or published Federal Register version) and a subsequent published correction notices (if applicable), all tables, additional data and analysis files and the impact file. For files related to the Long-Term Care Hospital PPS, please visit /Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.

FY 2021 Proposed Rule

CMS-1735-P

Date of Display: May 11, 2020

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2021 Rates; Quality Reporting and Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals.

Comment Period:  To be assured consideration, comments must be received no later than 5 p.m. EDT on July 10, 2020

Waiver of the 60-day Delayed Effective Date for the FY 2021 IPPS Final Rule: The United States is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that has now been detected in more than 190 locations internationally, including in all 50 States and the District of Columbia. The virus has been named “SARS CoV 2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID 19”). Due to the significant devotion of resources to the COVID-19 response, as discussed and for the reasons discussed in section XI.D. of the preamble of this propose rule, we are hereby waiving the 60 day delay in the effective date of the final rule, and replacing it with a 30 day delay in the effective date of the final rule.

FY 2021 Proposed Rule Data Files

1. Impact File FY 2021 Proposed Rule (ZIP)
2. AOR/BOR File FY 2021 Proposed Rule (ZIP)
3. Case Mix Index File FY 2021 Proposed Rule (ZIP)
4. HCRIS Data File FY 2021 Proposed Rule (ZIP)
5. Cost Center HCRIS Lines Supplemental Data File (ZIP)
6. Standardizing File FY 2021 Proposed Rule (ZIP)
7. FY 2021 Proposed Rule - County to CBSA Crosswalk File and Urban CBSAs and Constituent Counties for Acute Care Hospitals File (ZIP)
8. Wage Index Public Use Files FY 2021 Proposed Rule (ZIP)
9. Medicare DSH Supplemental Data File FY 2021 Proposed Rule (ZIP)
10. Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment for FY 2021: Note, this file will no longer be posted as all relevant information is available in Table 2.
11. FY 2022 New Technology Thresholds Proposed Rule (ZIP)

FY 2021 Proposed Rule Tables

1. Table 1A-1E (FY 2021 Proposed Operating and Capital National Standardized Amounts) (ZIP)
2. Tables 2, 3, 4A and 4B (FY 2021 Proposed Rule Wage Index Tables) (ZIP)
3. Table 5 (FY 2021 Proposed MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay) (ZIP)
4. Tables 6A-6K (FY 2021 ICD-10 Code Updates with Proposed MS-DRG Related Assignments) and Tables 6P.1a-6P.4a (Generally, Displays the ICD-10-CM and ICD-10-PCS codes for Proposed MS-DRG Issues) (ZIP)
5. Tables 7A and 7B (FY 2021 Number of Discharges, Selected Percentile LOS for MS-DRGs Version 37 and Proposed Version 38) (ZIP)
6. Tables 8A, 8B, and 8C (FY 2021 Proposed IPPS Operating and Capital Statewide Average CCRs and LTCH Statewide Average CCRs) (ZIP)
7. Table 16 (Proxy Hospital Value-Based Purchasing (VBP) Program Adjustment Factors for FY 2021) (ZIP)
8. Table 18 (Proposed FY 2021 Medicare DSH Uncompensated Care Payment Factor 3) (ZIP)