This is the home page for the FY 2022 Hospital Inpatient PPS final rule. The list below centralizes any IPPS file(s) related to the final  rule. The list contains the final 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 2022 IPPS Final Rule

1. CMS-1752-F

Date of Display: August 2, 2021

Date of Publication: August 13, 2021

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long‑Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Changes to Medicaid Provider Enrollment; and Changes to the Medicare Shared Savings Program

2. CMS-1752-F2

Date of Display: October 19, 2021

Date of Publication: October 20, 2021

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Changes to Medicaid Provider Enrollment; and Changes to the Medicare Shared Savings Program; Correction and Correcting Amendment.

3. CMS-1752-CN2

Date of Display: November 29, 2021

Date of Publication: November 30, 2021

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Changes to Medicaid Provider Enrollment; and Changes to the Medicare Shared Savings Program; Correction.

4. CMS-1752-FC3

Date of Display: December 17, 2021

Date of Publication: December 27, 2021

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; Changes to Medicare Graduate Medical Education Payments for Teaching Hospitals; Changes to Organ Acquisition Payment Policies

Comment Period: To be assured consideration, comments must be received no later than 5 p.m. EDT on February 25, 2022.

5. CMS-1752-CN3

Date of Display: January 26, 2022

Date of Publication: January 27, 2022

Title: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; Changes to Medicare Graduate Medical Education Payments for Teaching Hospitals; Changes to Organ Acquisition Payment Policies.

FY 2022 Final Rule, Correcting Amendment and Final Rule with Comment Period  Data Files

1. FY 2022 Final Rule and Correcting Amendment Impact File (ZIP): This file contains data elements by provider that were used in calculating the FY 2022 rates and impacts. 
2. AOR/BOR File (ZIP): This zip file for the FY 2022 final rule contains one excel spreadsheet with multiple tabs: one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two tabs containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance. 
3. Case Mix Index File (ZIP): This file contains the non-transfer adjusted case mix index (CMI) based on the MS-DRGs billed on the claim in the year the claim was incurred (that is, during FY 2019, using the V36 Grouper ).  
4. FY 2022 Final Rule: HCRIS Data File (ZIP): CMS uses hospital cost report data from the Medicare Cost Report, Hospital Form 2552-10, to calculate the Cost-to-Charge Ratios (CCRs) used in the cost based MS-DRG relative weight methodology.  The database for the Medicare cost reports is the Healthcare Cost Report Information System (HCRIS).  The CCRs used in the calculation of the MS DRG relative weights for the FY 2022 IPPS Final Rule are derived from the March 31, 2020 quarterly update of the FY 2018 HCRIS.   (HCRIS is updated on a quarterly basis).  
5. Cost Center HCRIS Lines Supplemental Data File (ZIP): This supplemental data file shows the cost report lines that are used for the Cost Center CCR calculations, which are part of the MS-DRG Relative Weights calculations.  
6. Standardizing File (ZIP): This file is used to standardize charges for the rate building process. 
7. County to CBSA Crosswalk File and Urban CBSAs and Constituent Counties for Acute Care Hospitals File (ZIP): This file contains two tabs: A crosswalk of county codes to CBSAs  and a list of Urban CBSAs and Constituent Counties for Acute Care Hospitals Files. 
8. FY 2022 Final Rule and Correcting Amendment Wage Index Public Use Files (ZIP): Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 5 zip files:
   • FY 2022 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
   • FY 2022 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
   • FY 2022 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
   • FY 2022 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
   • FY 2022 Final Rule AHW by Provider Area Listing  
9. FY 2022 IPPS Final Rule and Correcting Amendment: Medicare DSH Supplemental Data File (ZIP): This spreadsheet has 3 tabs (text files for each tab are included for Section 508 compliance):   The first tab is the File Layout for second tab of the spreadsheet. The second tab contains the final rule FY 2022 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments. The third tab contains a list of hospitals that have undergone a merger where the data of the merging hospitals have been combined to calculate the Factor 3 for the surviving hospital for FY 2022. 

10. Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment for FY 2022:

    Note, this file will no longer be posted as all relevant information is available in Table 2.
11. HRRP Supplemental File (ZIP): This file contains the final FY 2022 payment adjustment factors CMS applies to discharges that occur on or after October 1, 2021. It also contains information on the number of discharges used to determine the ratio of condition/procedure-specific payments to total base operating diagnosis-related (DRG) payments. 
12. FY 2023 New Technology Thresholds Final Rule and Correcting Amendment (ZIP): Contains the cost thresholds by MS-DRG for the cost criteria for new technology add-on payments for applications for FY 2023.
13. Health Professional Shortage Area (HPSA) Public IDs and Scores (ZIP) (ZIP): Contains the HPSA Public IDs and their corresponding scores current as of November 1, 2021.  This information is to assist hospitals in the graduate medical education section 126 application process for the distribution of additional residency positions for the coming year.
14. FYS 1995 AND 1996 AND COST REPORT FORM-2552-96 GME DATA (ZIP): Contains GME data from FYs 1995 and 1996 and GME data from when the CMS FORM-2552-96 cost report form was in effect (approximately FY 1997 through partial FY 2010).
15. COST REPORT FORM-2552-10 GME DATA (ZIP): Contains GME data from the CMS-FORM-2552-10 cost report form currently in effect (approximately from partial FY 2010 through partial FY 2020, which is the best available data accessed from the September 30, 2021 quarterly update of HCRIS).

FY 2022 Final Rule and Correcting Amendment Tables

1. Table 1A-1E Final Rule and Correcting Amendment (ZIP) (ZIP): This excel spreadsheet contains the FY 2022 Operating and Capital National Standardized Amounts. https://www.cms.gov/files/zip/table-1a-1e-fy-2022-operating-and-capital-national-standardized-amounts.zip
2. FY 2022 Final Rule and Correcting Amendment Tables 2, 3, 4A and 4B (Wage Index Tables) (ZIP): Table 2- Case-Mix Index and Wage Index Table by CMS Certification Number (CCN); Table 3-  Wage Index Table by CBSA; Table 4A - List of Counties Eligible for the Out-Migration Adjustment under Section 1886(d)(13) of the Act; Table 4B - Counties Redesignated under Section 1886(d)(8)(B) of the Act (LUGAR COUNTIES)
3. Table 5 (ZIP): MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay
4. Tables 6A-6J and Tables 6P.1a-6P.3a Final Rule and Correcting Amendment (ZIP): Table 6A-New Diagnosis Codes; Table 6B-New Procedure Codes; Table 6C-Invalid Diagnosis Codes; Table 6D-Invalid Procedure Codes; Table 6E-Revised Diagnosis Code Titles; Table 6F-Revised Procedure Code Titles; Table 6G.1- Secondary Diagnosis Order Additions to the CC Exclusions List; Table 6G.2- Principal Diagnosis Order Additions to the CC Exclusions List; Table 6H.1- Secondary Diagnosis Order Deletions to the CC Exclusions List; Table 6H.2- Principal Diagnosis Order Deletions to the CC Exclusions List; Table 6I – Complete MCC List; Table 6I.1- Additions to the MCC List; Table 6I.2- Deletions to the MCC List; Table 6J – Complete CC List; Table 6J.1- Additions to the CC List; Table 6J.2- Deletions to the CC List; Table 6K-Complete List of CC Exclusions; Tables 6P.1a-6P.2c (ICD-10-CM and ICD-10-PCS Codes for MS-DRG Changes): See summary tab in excel spreadsheet called “CMS-1752-F TABLE 6P ICD-10-CM and ICD-10-PCS Codes for MS-DRG Changes.xlsx” for a complete description of all tables. Table 6P.3a (Medicare Code Editor Unspecified Codes List): See summary tab in excel spreadsheet called “CMS-1752-F TABLE 6P.3a ICD-10-CM Codes finalized for Unspecified Code Edit in the Medicare Code Editor.xlsx” for complete description of the table.
5. Tables 7A and 7B (ZIP): Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 38 and MS-DRGs, version 39.
6. Tables 8A, 8B, and 8C (ZIP) (ZIP):Tables 8A and 8B contain the FY 2022 IPPS operating and capital statewide average cost-to-charge-ratios. Table 8C contains the FY 2022 LTCH statewide average cost-to-charge-ratios.
7. Table 15: FY 2022 Hospital Readmissions Reduction Program Payment Adjustment Factors (ZIP): This table contains the final FY 2022 payment adjustment factors CMS applies to discharges occurring on or after October 1, 2021.
8. Table 16 and 16B: Hospital Value-Based Purchasing (VBP) Program Adjustment Factors: Note, this table is not necessary for FY 2022.
9. Table 18 Final Rule and Correcting Amendment (ZIP): FY 2022 Medicare DSH Uncompensated Care Payment Factor 3

FY 2022 MAC Implementation Files

This page contains the following files as described in the Fiscal Year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes Change Request (CR) 12373.

1. MAC Implementation File 1 (ZIP) – Certain FY 2022 IPPS factors, including applicable percentage increase, budget neutrality factors, High Cost Outlier (HCO) threshold, and Cost-of-Living adjustment (COLA) factors. 
2. MAC Implementation File 2 (ZIP) – Certain FY 2022 LTCH PPS factors, including High Cost Outlier (HCO) threshold, and Cost-of-Living adjustment (COLA) factors.  
3. MAC Implementation File 3 (ZIP)  – A list of hospitals that will receive the statutory reduction to the annual payment update for FY 2021 under the Hospital Inpatient Quality Reporting (IQR) Program.
4. MAC Implementation File 4 – LUGAR county list (Note: For FY 2022, The LUGAR county list is available in Table 4B which can be found on the FY 2022 IPPS Final Rule Home Page, https://www.cms.gov/medicare/acute-inpatient-pps/fy-2022-ipps-final-rule-home-page, listed under the FY 2022 Final Rule Tables).
5. MAC Implementation File 5 (ZIP) – Instructions to Fill Out the PSF for the Wage Index and Reclassification. 
6. MAC Implementation File 6 (ZIP) – FY 2022 MS-DRG Grouper Changes.
7. MAC Implementation File 7 (ZIP) – FY 2022 MS-DRGs Subject to the Replaced Devices Policy.
8. MAC Implementation File 8 (ZIP) (Note: This file was updated on November 1, 2021) – FY 2022 New Technology Add-on Payment.