68486 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 

3, the reference ‘‘(April 2022)’’ is 

corrected to read ‘‘(June 2023)’’. 

21. On page 59163: 

a. First column, last paragraph, lines 

3 through 4, the phrase ‘‘Hybrid 

Hospital-Wide Mortality (Hybrid HWM) 

measure’’ is corrected to read ‘‘Hybrid 

Hospital-Wide All-Cause Risk 

Standardized Mortality (HWM) 

measure’’. 

b. Second column, second footnote 

paragraph (footnote 525), line 3, the 

footnote is corrected by adding the 

following sentence ‘‘Available at: 

https://pubmed.ncbi.nlm.nih.gov/ 

25068076/.’’. 

22. On page 59164, second column, 

second full paragraph, line 18, the 

reference ‘‘section B.6.d’’ is corrected to 

read ‘‘section XII.B.7.d.’’. 

23. On page 59167, third column, 

third paragraph, lines 3 through 4, the 

phrase ‘‘Hybrid Hospital-Wide 

Readmission (Hybrid HWR) measure’’ is 

corrected to read ‘‘Hybrid HospitalWide All-Cause Readmission (HWR) 

measure’’. 

24. On page 59171, second column, 

second full paragraph, line 13, the 

reference ‘‘section X.k’’ is corrected to 

read ‘‘section V.K.’’. 

25. On page 59174, second column, 

second footnote paragraph (footnote 

565), lines 3 through 4, the hyperlink, 

‘‘https://manual.jointcommissionorg/

releases/TJC2023B/MIF0166.html’’ is 

corrected to read ‘‘https://manual.joint

commission.org/releases/TJC2023B/

MIF0166.html’’. 

26. On page 59180, first column, first 

paragraph, lines 1 through 4, the section 

heading, ‘‘c. Summary of Previously 

Finalized and Proposed Hospital IQR 

Program Measures’’ is corrected to read 

‘‘c. Summary of Previously Finalized 

and Newly Adopted Hospital IQR 

Program Measures’’. 

27. On page 59186, third column, 

sixth full footnote paragraph (footnote 

583), lines 4 through 6, the website 

‘‘https://forms.ihi.org/hubfs/ 

Guide%20To

%20Recognition%20for%20GSV%20

Siteslowbar;FINAL.pdf’’ is corrected to 

read ‘‘https://forms.ihi.org/hubfs/

Guide%20To%20Recognition%20for

%20GSV%20Sites_FINAL.pdf’’. 

28. On page 59199, third column, 

fourth full paragraph, lines 3 through 4, 

the phrase ‘‘On commenter’’ is corrected 

to read ‘‘One commenter’’. 

29. On page 59279, second paragraph 

(table key for Table IX.F.-04.), the word 

‘‘pubslihing’’ is corrected to read 

‘‘appearing’’. 

30. On page 59326, second column, 

first paragraph, line 7, the phrase ‘‘per 

eligible.’’ is corrected to read ‘‘per 

eligible hospital and CAH as well as an 

additional 4 hours annually for CAHs to 

report eCQMs.’’. 

B. Correction of Errors in the 

Appendices 

1. On page 59412, second column, 

first full paragraph, line 8, the table 

reference ‘‘Table I.G.-01’’ is corrected to 

read ‘‘Table I.G.-03’’. 

Wilma Robinson, 

Deputy Executive Secretary, Department of 

Health and Human Services. 

[FR Doc. 2023–22060 Filed 9–29–23; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 411, 413, 488, and 489 

[CMS–1779–CN] 

RIN 0938–AV02 

Medicare Program; Prospective 

Payment System and Consolidated 

Billing for Skilled Nursing Facilities; 

Updates to the Quality Reporting 

Program and Value-Based Purchasing 

Program for Federal Fiscal Year 2024; 

Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors in the final rule that 

appeared in the August 7, 2023 Federal 

Register, entitled ‘‘Medicare Program; 

Prospective Payment System and 

Consolidated Billing for Skilled Nursing 

Facilities; Updates to the Quality 

Reporting Program and Value-Based 

Purchasing Program for Federal Fiscal 

Year 2024’’ (referred to hereafter as the 

‘‘FY 2024 SNF final rule’’). The effective 

date of the FY 2024 SNF final rule is 

October 1, 2023. 

DATES: This document is effective 

October 1, 2023. 

FOR FURTHER INFORMATION CONTACT: 

John Kane, (410) 786–0557, for 

information related to the SNF PPS. 

Kia Burwell, (410) 786–7816, for 

information related to the SNF wage 

index. 

Tammy Luo, (410) 786–4325, for 

information related to the PDPM ICD–10 

mappings. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2023–16249 of August 7, 

2023 (88 FR 53200), there were 

technical errors that are identified and 

corrected in this correcting document. 

These corrections are effective as if they 

had been included in the FY 2024 SNF 

final rule. Accordingly, the corrections 

are effective October 1, 2023. 

II. Summary of Errors 

A. Summary of Errors in the Preamble 

A technical error in the calculation of 

the final FY 2024 SNF PPS wage 

indexes required us to recalculate the 

wage index budget neutrality factor; the 

unadjusted SNF PPS Federal per diem 

rates provided on page 53209 in Tables 

3 and 4; the case-mix adjusted SNF PPS 

rates provided on pages 53210 through 

53211 in Tables 5 and 6; figures on 

pages 53214, 53215; Tables 8 and 9 on 

page 53215; Table 10 on pages 53215 

through 53216; a figure on page 53333; 

and the impact analysis provided on 

pages 53333 through 53334 in Table 30. 

Further discussions of these errors are 

found in section IV. of this document. 

On page 53333, we made a 

typographical error in a percent 

increase. 

B. Summary of Errors and Corrections 

Posted on the CMS Website 

1. SNF Wage Index 

As discussed in the FY 2024 SNF PPS 

final rule (88 FR 53211 through 53214), 

in developing the wage index to be 

applied to SNFs under the SNF PPS, we 

use the updated, pre-reclassified, prerural floor hospital inpatient PPS (IPPS) 

wage data, exclusive of the occupational 

mix adjustment. For FY 2024, the 

updated, unadjusted, pre-reclassified, 

pre-rural floor IPPS wage data used 

under the SNF PPS are for cost reporting 

periods beginning on or after October 1, 

2019, and before October 1, 2020 (FY 

2020 cost report data), as discussed in 

the final rule entitled ‘‘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 

2024 Rates; Quality Programs and 

Medicare Promoting Interoperability 

Program Requirements for Eligible 

Hospitals and Critical Access Hospitals; 

Rural Emergency Hospital and 

Physician-Owned Hospital 

Requirements; and Provider and 

Supplier Disclosure of Ownership; and 

Medicare Disproportionate Share 

Hospital (DSH) Payments: Counting 

Certain Days Associated with Section 

1115 Demonstrations in the Medicaid 

Fraction’’ (88 FR 58640) (hereinafter 

referred to as the FY 2024 IPPS final 

rule). In calculating the wage index 

under the FY 2024 IPPS final rule, we 


lotter on DSK11XQN23PROD with RULES1
Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 68487 

made an inadvertent error related to the 

calculation of the wage index. This error 

is identified, discussed, and corrected in 

the document entitled ‘‘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 

2024 Rates; Quality Programs and 

Medicare Promoting Interoperability 

Program Requirements for Eligible 

Hospitals and Critical Access Hospitals; 

Rural Emergency Hospital and 

Physician-Owned Hospital 

Requirements; and Provider and 

Supplier Disclosure of Ownership; and 

Medicare Disproportionate Share 

Hospital (DSH) Payments: Counting 

Certain Days Associated with Section 

1115 Demonstrations in the Medicaid 

Fraction; Correction,’’ published 

elsewhere in this issue of the Federal 

Register. The error that affects the 

unadjusted, pre-reclassified, pre-rural 

floor IPPS wage data and thereby affects 

the SNF PPS wage data was an error in 

the wage data collected from the 

Medicare cost reports of one hospital 

(CMS Certification Number (CCN) 

340064—Core-Based Statistical Area 

(CBSA) 34 rural North Carolina). 

As discussed previously in this 

section, we use the updated, prereclassified, unadjusted IPPS wage data 

in developing the wage index used 

under the SNF PPS. Due to the technical 

errors described previously in this 

section, the published FY 2024 SNF PPS 

wage indexes were incorrect. Thus, the 

use of the corrected wage data for the 

one hospital in CBSA 34 required us to 

recalculate the final FY 2024 SNF PPS 

wage indexes. Additionally, as 

discussed in the FY 2024 SNF PPS final 

rule, section 1888(e)(4)(G)(ii) of the 

Social Security Act requires that we 

apply the wage index in a manner that 

does not result in aggregate payments 

under the SNF PPS that are greater or 

less than would otherwise be made if 

the wage index adjustment had not been 

made (88 FR 53214). To achieve this, we 

apply a budget neutrality factor to the 

unadjusted SNF PPS Federal per diem 

base rates. This revision of the final FY 

2024 SNF PPS wage indexes requires us 

to recalculate wage index budget 

neutrality factor; the unadjusted SNF 

PPS Federal per diem rates provided in 

Tables 3 and 4 of the FY 2024 SNF PPS 

final rule (88 FR 53209); the case-mix 

adjusted SNF PPS rates provided in 

Tables 5 and 6 in the FY 2024 SNF PPS 

final rule (88 FR 53210 through 53211); 

and the impact analysis provided in 

Table 30 of the FY 2024 SNF PPS final 

rule (88 FR 53333 through 53334). The 

corrections to these errors are found in 

section IV. of this document. 

We are correcting the wage index in 

Table B setting forth the wage indexes 

for rural areas based on CBSA labor 

market areas (Table B), which is 

available exclusively on the CMS 

website at https://www.cms.gov/ 

Medicare/Medicare-Fee-for-ServicePayment/SNFPPS/WageIndex.html. 

Table B has been updated to reflect the 

error discussed in this correcting 

document, and we are republishing the 

wage indexes in Tables A and B 

accordingly on the CMS website at 

https://www.cms.gov/Medicare/ 

Medicare-Fee-for-Service-Payment/ 

SNFPPS/WageIndex.html. 

2. PDPM ICD–10 Mappings 

We are correcting the following errors 

to the FY 2024 Patient Driven Payment 

Model (PDPM) ICD–10–CM mappings 

(hereinafter referred to as PDPM ICD–10 

code mappings) that were made 

available on the CMS website at https:// 

www.cms.gov/medicare/medicare-feefor-service-payment/snfpps/pdpm in 

conjunction with the release of the FY 

2024 SNF PPS final rule. The FY 2024 

PDPM ICD–10 code mappings file may 

be accessed from the list of items under 

the ‘‘PDPM Resources’’ section of the 

website with an effective date of ‘‘10– 

01–2023.’’ The preamble language of FY 

2024 SNF PPS final rule discussing 

ICD–10 mappings is unaffected by these 

errors. 

The first table in the FY 2024 PDPM 

ICD–10 code mappings file displays the 

list of ICD–10 codes that are recorded in 

Item I0020B ICD Code of the Minimum 

Data Set (MDS) assessment to determine 

a patient’s clinical category assignment 

under PDPM. First, we are correcting 

errors in the clinical category 

assignment of 332 codes ranging from 

C00.0 through C49.6 to reinstate their 

prior year’s assignments from the FY 

2023 SNF PPS final rule, as we 

proposed no changes in clinical 

categories in this code range in the FY 

2024 SNF PPS proposed rule nor 

finalized them in the FY 2024 SNF PPS 

final rule. Second, we are correcting 

errors in the clinical category 

assignments of D75.84, F43.81, F43.89, 

G90.A, and K76.82 to reflect the changes 

finalized in the FY 2024 SNF PPS final 

rule (88 FR 53220 through 53221). 

The second table in the FY 2024 

PDPM ICD–10 code mappings file 

displays a list of ICD–10 codes 

associated with comorbidities included 

in the Speech-Language Pathology (SLP) 

component under PDPM. Specifically, 

we are removing the following new 

ICD–10 codes effective October 1, 2023, 

that were erroneously added, noting the 

addition of any ICD–10 code to the SLP 

comorbidity list would amount to a 

change in policy that would first need 

to undergo notice and comment 

rulemaking: G20.A1, G20.A2, G20.B1, 

G20.B2, G20.C, G11.6, G23.3, G31.80, 

G31.86, G37.81, G40.C01, G40.C09, 

G40.C11, G40.C19, G90.B, G93.42, 

G93.43, G93.44. 

Given these errors, we are 

republishing the PDPM ICD–10 code 

mappings accordingly on the CMS 

website at https://www.cms.gov/ 

medicare/medicare-fee-for-servicepayment/snfpps/pdpm effective October 

1, 2023. 

III. Waiver of Proposed Rulemaking 

Under section 553(b) of the 

Administrative Procedure Act (the APA) 

(5 U.S.C. 553(b)), the agency is required 

to publish a notice of proposed 

rulemaking in the Federal Register 

before the provisions of a rule take 

effect. Similarly, section 1871(b)(1) of 

the Social Security Act (the Act) 

requires the Secretary to provide for 

notice of the proposed rule in the 

Federal Register and provide a period of 

not less than 60 days for public 

comment. In addition, section 553(d) of 

the APA and section 1871(e)(1)(B)(i) of 

the Act mandate a 30-day delay in 

effective date after issuance or 

publication of a rule. Sections 553(b)(B) 

and 553(d)(3) of the APA provide for 

exceptions from the APA notice and 

comment, and delay in effective date 

requirements; in cases in which these 

exceptions apply, sections 1871(b)(2)(C) 

and 1871(e)(1)(B)(ii) of the Act provide 

exceptions from the notice and 60-day 

comment period and delay in effective 

date requirements of the Act as well. 

Section 553(b)(B) of the APA and 

section 1871(b)(2)(C) of the Act 

authorize an agency to dispense with 

normal notice and comment rulemaking 

procedures for good cause if the agency 

makes a finding that the notice and 

comment process is impracticable, 

unnecessary, or contrary to the public 

interest, and includes a statement of the 

finding and the reasons for it in the rule. 

In addition, section 553(d)(3) of the 

APA and section 1871(e)(1)(B)(ii) allow 

the agency to avoid the 30-day delay in 

effective date where such delay is 

contrary to the public interest and the 

agency includes in the rule a statement 

of the finding and the reasons for it. 

In our view, this correcting document 

does not constitute a rulemaking that 

would be subject to these requirements. 

This document merely corrects 

technical errors in the FY 2024 SNF 

final rule. The corrections contained in 

this document are consistent with, and 

do not make substantive changes to, the 


lotter on DSK11XQN23PROD with RULES1
68488 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 

policies and payment methodologies 

that were proposed, subject to notice 

and comment procedures, and adopted 

in the FY 2024 SNF final rule. As a 

result, the corrections made through this 

correcting document are intended to 

resolve inadvertent errors so that the 

rule accurately reflects the policies 

adopted in the final rule. Even if this 

were a rulemaking to which the notice 

and comment and delayed effective date 

requirements applied, we find that there 

is good cause to waive such 

requirements. Undertaking further 

notice and comment procedures to 

incorporate the corrections in this 

document into the FY 2024 SNF final 

rule or delaying the effective date of the 

corrections would be contrary to the 

public interest because it is in the 

public interest to ensure that the rule 

accurately reflects our policies as of the 

date they take effect. Further, such 

procedures would be unnecessary 

because we are not making any 

substantive revisions to the final rule, 

but rather, we are simply correcting the 

Federal Register document to reflect the 

policies that we previously proposed, 

received public comment on, and 

subsequently finalized in the final rule. 

For these reasons, we believe there is 

good cause to waive the requirements 

for notice and comment and delay in 

effective date. 

IV. Correction of Errors in the Preamble 

In FR Doc. 2023–16249 of August 7, 

2023 (88 FR 53200), make the following 

corrections: 

1. On page 53209, middle of the page: 

a. TABLE 3—FY 2024 UNADJUSTED 

FEDERAL RATE PER DIEM—URBAN is 

corrected to read as follows: 

TABLE 3—FY 2024 UNADJUSTED FEDERAL RATE PER DIEM—URBAN 

Rate component PT OT SLP Nursing NTA Non-case-mix 

Per Diem Amount .................................... $70.26 $65.40 $26.23 $122.47 $92.40 $109.68 

b. TABLE 4—FY 2024 UNADJUSTED 

FEDERAL RATE PER DIEM—RURAL is 

corrected to read as follows: 

TABLE 4—FY 2024 UNADJUSTED FEDERAL RATE PER DIEM—RURAL 

Rate component PT OT SLP Nursing NTA Non-case-mix 

Per Diem Amount .................................... $80.09 $73.56 $33.05 $117.01 88.28 $111.71 

2. On page 53210, bottom of the page, 

TABLE 5—PDPM CASE-MIX 

ADJUSTED FEDERAL RATES AND 

ASSOCIATED INDEXES—URBAN 

(INCLUDING THE PARITY 

ADJUSTMENT RECALIBRATION) is 

corrected to read as follows: 

TABLE 5—PDPM CASE-MIX ADJUSTED FEDERAL RATES AND ASSOCIATED INDEXES—URBAN (INCLUDING THE PARITY

ADJUSTMENT RECALIBRATION) 

PDPM 

group PT CMI PT rate OT CMI OT rate SLP CMI SLP rate Nursing CMG 

Nursing 

CMI 

Nursing 

rate NTA CMI NTA rate 

A ........... 1.45 $101.88 1.41 $92.21 0.64 $16.79 ES3 3.84 $470.28 3.06 $282.74 

B ........... 1.61 113.12 1.54 100.72 1.72 45.12 ES2 2.90 355.16 2.39 220.84 

C ........... 1.78 125.06 1.60 104.64 2.52 66.10 ES1 2.77 339.24 1.74 160.78 

D ........... 1.81 127.17 1.45 94.83 1.38 36.20 HDE2 2.27 278.01 1.26 116.42 

E ........... 1.34 94.15 1.33 86.98 2.21 57.97 HDE1 1.88 230.24 0.91 84.08 

F ........... 1.52 106.80 1.51 98.75 2.82 73.97 HBC2 2.12 259.64 0.68 62.83 

G ........... 1.58 111.01 1.55 101.37 1.93 50.62 HBC1 1.76 215.55 ................ ................

H ........... 1.10 77.29 1.09 71.29 2.7 70.82 LDE2 1.97 241.27 ................ ................

I ............ 1.07 75.18 1.12 73.25 3.34 87.61 LDE1 1.64 200.85 ................ ................

J ............ 1.34 94.15 1.37 89.60 2.83 74.23 LBC2 1.63 199.63 ................ ................

K ........... 1.44 101.17 1.46 95.48 3.5 91.81 LBC1 1.35 165.33 ................ ................

L ........... 1.03 72.37 1.05 68.67 3.98 104.40 CDE2 1.77 216.77 ................ ................

M .......... 1.20 84.31 1.23 80.44 ................ ................ CDE1 1.53 187.38 ................ ................

N ........... 1.40 98.36 1.42 92.87 ................ ................ CBC2 1.47 180.03 ................ ................

O ........... 1.47 103.28 1.47 96.14 ................ ................ CA2 1.03 126.14 ................ ................

P ........... 1.02 71.67 1.03 67.36 ................ ................ CBC1 1.27 155.54 ................ ................

Q ........... ................ ................ ................ ................ ................ ................ CA1 0.89 109.00 ................ ................

R ........... ................ ................ ................ ................ ................ ................ BAB2 0.98 120.02 ................ ................

S ........... ................ ................ ................ ................ ................ ................ BAB1 0.94 115.12 ................ ................

T ........... ................ ................ ................ ................ ................ ................ PDE2 1.48 181.26 ................ ................

U ........... ................ ................ ................ ................ ................ ................ PDE1 1.39 170.23 ................ ................

V ........... ................ ................ ................ ................ ................ ................ PBC2 1.15 140.84 ................ ................

W .......... ................ ................ ................ ................ ................ ................ PA2 0.67 82.05 ................ ................

X ........... ................ ................ ................ ................ ................ ................ PBC1 1.07 131.04 ................ ................

Y ........... ................ ................ ................ ................ ................ ................ PA1 0.62 75.93 ................ ................


lotter on DSK11XQN23PROD with RULES1
Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 68489 

3. On page 53211, top of the page, 

TABLE 6—PDPM CASE-MIX 

ADJUSTED FEDERAL RATES AND 

ASSOCIATED INDEXES—RURAL 

(INCLUDING THE PARITY 

ADJUSTMENT RECALIBRATION) is 

corrected to read as follows: 

TABLE 6—PDPM CASE-MIX ADJUSTED FEDERAL RATES AND ASSOCIATED INDEXES—RURAL (INCLUDING THE PARITY

ADJUSTMENT RECALIBRATION) 

PDPM 

group PT CMI PT rate OT CMI OT rate SLP CMI SLP rate Nursing CMG 

Nursing 

CMI 

Nursing 

rate NTA CMI NTA rate 

A ........... 1.45 $116.13 1.41 $103.72 0.64 $21.15 ES3 3.84 $449.32 3.06 $270.14 

B ........... 1.61 128.94 1.54 113.28 1.72 56.85 ES2 2.90 339.33 2.39 210.99 

C ........... 1.78 142.56 1.60 117.70 2.52 83.29 ES1 2.77 324.12 1.74 153.61 

D ........... 1.81 144.96 1.45 106.66 1.38 45.61 HDE2 2.27 265.61 1.26 111.23 

E ........... 1.34 107.32 1.33 97.83 2.21 73.04 HDE1 1.88 219.98 0.91 80.33 

F ........... 1.52 121.74 1.51 111.08 2.82 93.20 HBC2 2.12 248.06 0.68 60.03 

G ........... 1.58 126.54 1.55 114.02 1.93 63.79 HBC1 1.76 205.94 ................ ................

H ........... 1.10 88.10 1.09 80.18 2.7 89.24 LDE2 1.97 230.51 ................ ................

I ............ 1.07 85.70 1.12 82.39 3.34 110.39 LDE1 1.64 191.90 ................ ................

J ............ 1.34 107.32 1.37 100.78 2.83 93.53 LBC2 1.63 190.73 ................ ................

K ........... 1.44 115.33 1.46 107.40 3.5 115.68 LBC1 1.35 157.96 ................ ................

L ........... 1.03 82.49 1.05 77.24 3.98 131.54 CDE2 1.77 207.11 ................ ................

M .......... 1.20 96.11 1.23 90.48 ................ ................ CDE1 1.53 179.03 ................ ................

N ........... 1.40 112.13 1.42 104.46 ................ ................ CBC2 1.47 172.00 ................ ................

O ........... 1.47 117.73 1.47 108.13 ................ ................ CA2 1.03 120.52 ................ ................

P ........... 1.02 81.69 1.03 75.77 ................ ................ CBC1 1.27 148.60 ................ ................

Q ........... ................ ................ ................ ................ ................ ................ CA1 0.89 104.14 ................ ................

R ........... ................ ................ ................ ................ ................ ................ BAB2 0.98 114.67 ................ ................

S ........... ................ ................ ................ ................ ................ ................ BAB1 0.94 109.99 ................ ................

T ........... ................ ................ ................ ................ ................ ................ PDE2 1.48 173.17 ................ ................

U ........... ................ ................ ................ ................ ................ ................ PDE1 1.39 162.64 ................ ................

V ........... ................ ................ ................ ................ ................ ................ PBC2 1.15 134.56 ................ ................

W .......... ................ ................ ................ ................ ................ ................ PA2 0.67 78.40 ................ ................

X ........... ................ ................ ................ ................ ................ ................ PBC1 1.07 125.20 ................ ................

Y ........... ................ ................ ................ ................ ................ ................ PA1 0.62 72.55 ................ ................

4. On page 53214, first column, first 

full paragraph, line 27, the figure 

‘‘0.9997’’ is corrected to read ‘‘0.9996’’. 

5. On page 53215, above Table 8, third 

column, first partial paragraph, line 7, 

the figure ‘‘$21,717.98’’ is corrected to 

read ‘‘$21,715.82’’. 

6. On page 53215, middle of the page, 

TABLE 8—PDPM CASE-MIX 

ADJUSTED RATE COMPUTATION 

EXAMPLE is corrected to read as 

follows: 

TABLE 8—PDPM CASE-MIX ADJUSTED RATE COMPUTATION EXAMPLE

Per diem rate calculation 

Component Component 

group 

Component 

rate 

VPD 

adjustment 

factor 

VPD 

adj. rate 

PT ........................................................................................................................ N $98.36 1.00 $98.36 

OT ........................................................................................................................ N 92.87 1.00 92.87 

SLP ...................................................................................................................... H 70.82 1.00 70.82 

Nursing ................................................................................................................ N 180.03 1.00 180.03 

NTA ...................................................................................................................... C 160.78 3.00 482.34 

Non-Case-Mix ...................................................................................................... 109.68 ........................ 109.68 

Total PDPM Case-Mix Adj. Per Diem .......................................................... ........................ ........................ 1,034.10 

7. On page 53215, middle of the page, 

TABLE 9—WAGE INDEX ADJUSTED 

RATE COMPUTATION EXAMPLE is 

corrected to read as follows: 


lotter on DSK11XQN23PROD with RULES1
68490 Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 

TABLE 9—WAGE INDEX ADJUSTED RATE COMPUTATION EXAMPLE

PDPM wage index adjustment calculation 

HIPPS code 

PDPM 

case-mix 

adjusted 

per diem 

Labor portion Wage index Wage index 

adjusted rate 

Non-labor 

portion 

Total case 

mix and wage 

index adj. rate 

NHNC1 ..................................................... $1,034.10 $735.25 0.9637 $708.56 $298.85 $1,007.41 

8. On pages 53215 through 53216, 

TABLE 10—ADJUSTED RATE 

COMPUTATION EXAMPLE is corrected 

to read as follows: 

TABLE 10—ADJUSTED RATE COMPUTATION EXAMPLE

Day of stay 

NTA VPD 

adjustment 

factor 

PT/OT VPD 

adjustment 

factor 

Case mix and 

wage index 

adjusted per 

diem rate 

1 ................................................................................................................................................... 3.0 1.0 $1,007.41 

2 ................................................................................................................................................... 3.0 1.0 1,007.41 

3 ................................................................................................................................................... 3.0 1.0 1,007.41 

4 ................................................................................................................................................... 1.0 1.0 694.15 

5 ................................................................................................................................................... 1.0 1.0 694.15 

6 ................................................................................................................................................... 1.0 1.0 694.15 

7 ................................................................................................................................................... 1.0 1.0 694.15 

8 ................................................................................................................................................... 1.0 1.0 694.15 

9 ................................................................................................................................................... 1.0 1.0 694.15 

10 ................................................................................................................................................. 1.0 1.0 694.15 

11 ................................................................................................................................................. 1.0 1.0 694.15 

12 ................................................................................................................................................. 1.0 1.0 694.15 

13 ................................................................................................................................................. 1.0 1.0 694.15 

14 ................................................................................................................................................. 1.0 1.0 694.15 

15 ................................................................................................................................................. 1.0 1.0 694.15 

16 ................................................................................................................................................. 1.0 1.0 694.15 

17 ................................................................................................................................................. 1.0 1.0 694.15 

18 ................................................................................................................................................. 1.0 1.0 694.15 

19 ................................................................................................................................................. 1.0 1.0 694.15 

20 ................................................................................................................................................. 1.0 1.0 694.15 

21 ................................................................................................................................................. 1.0 0.98 690.42 

22 ................................................................................................................................................. 1.0 0.98 690.42 

23 ................................................................................................................................................. 1.0 0.98 690.42 

24 ................................................................................................................................................. 1.0 0.98 690.42 

25 ................................................................................................................................................. 1.0 0.98 690.42 

26 ................................................................................................................................................. 1.0 0.98 690.42 

27 ................................................................................................................................................. 1.0 0.98 690.42 

28 ................................................................................................................................................. 1.0 0.96 686.70 

29 ................................................................................................................................................. 1.0 0.96 686.70 

30 ................................................................................................................................................. 1.0 0.96 686.70 

Total Payment ...................................................................................................................... ........................ ........................ 21,715.82 

9. On page 53333, third column, 

fourth full paragraph, line 6, the figure 

‘‘3.0’’ is corrected to read ‘‘3.3’’. 

10. On pages 53333 through 53334, 

TABLE 30—IMPACT TO THE SNF PPS 

FOR FY 2024 is corrected to read as 

follows: 

TABLE 30—IMPACT TO THE SNF PPS FOR FY 2024 

Impact categories Number of 

facilities 

Parity 

adjustment 

recalibration 

(%) 

Update wage 

data 

(%) 

Total change 

(%) 

Group 

Total ................................................................................................................. 15,503 ¥2.3 0.0 4.0 

Urban ............................................................................................................... 11,254 ¥2.3 0.1 4.1 

Rural ................................................................................................................ 4,249 ¥2.2 ¥0.7 3.3 

Hospital-based urban ....................................................................................... 366 ¥2.3 0.0 4.0 

Freestanding urban .......................................................................................... 10,888 ¥2.3 0.1 4.1 

Hospital-based rural ......................................................................................... 378 ¥2.2 ¥0.3 3.7 


lotter on DSK11XQN23PROD with RULES1
Federal Register / Vol. 88, No. 191 / Wednesday, October 4, 2023 / Rules and Regulations 68491 

TABLE 30—IMPACT TO THE SNF PPS FOR FY 2024—Continued 

Impact categories Number of 

facilities 

Parity 

adjustment 

recalibration 

(%) 

Update wage 

data 

(%) 

Total change 

(%) 

Freestanding rural ............................................................................................ 3,871 ¥2.2 ¥0.7 3.3 

Urban by region 

New England ................................................................................................... 734 ¥2.3 ¥0.7 3.2 

Middle Atlantic ................................................................................................. 1,471 ¥2.4 1.3 5.3 

South Atlantic ................................................................................................... 1,945 ¥2.3 0.1 4.1 

East North Central ........................................................................................... 2,181 ¥2.3 ¥0.7 3.2 

East South Central .......................................................................................... 555 ¥2.2 0.0 4.0 

West North Central .......................................................................................... 958 ¥2.3 ¥0.4 3.6 

West South Central ......................................................................................... 1,454 ¥2.3 0.0 4.0 

Mountain .......................................................................................................... 546 ¥2.3 ¥0.9 3.0 

Pacific .............................................................................................................. 1,404 ¥2.4 0.1 4.0 

Outlying ............................................................................................................ 6 ¥2.0 ¥2.6 1.6 

Rural by region 

New England ................................................................................................... 117 ¥2.3 ¥1.1 2.8 

Middle Atlantic ................................................................................................. 205 ¥2.2 ¥0.3 3.7 

South Atlantic ................................................................................................... 489 ¥2.2 0.1 4.2 

East North Central ........................................................................................... 907 ¥2.2 ¥0.9 3.1 

East South Central .......................................................................................... 491 ¥2.2 ¥0.8 3.2 

West North Central .......................................................................................... 1,011 ¥2.2 ¥0.9 3.1 

West South Central ......................................................................................... 738 ¥2.2 ¥0.5 3.5 

Mountain .......................................................................................................... 199 ¥2.3 ¥0.7 3.3 

Pacific .............................................................................................................. 91 ¥2.3 ¥2.0 1.9 

Outlying ............................................................................................................ 1 ¥2.3 0.1 3.9 

Ownership 

For profit .......................................................................................................... 10,912 ¥2.3 0.0 4.0 

Non-profit ......................................................................................................... 3,573 ¥2.3 0.0 3.9 

Government ..................................................................................................... 1,018 ¥2.3 ¥0.4 3.6 

Note: The Total column includes the FY 2024 6.4 percent market basket update. The values presented in Table 30 may not sum due to 

rounding. 

Wilma Robinson, 

Deputy Executive Secretary, Department of 

Health and Human Services. 

[FR Doc. 2023–22050 Filed 9–29–23; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Part 412 

[CMS–1783–CN] 

RIN 0938–AV06 

Medicare Program; FY 2024 Inpatient 

Psychiatric Facilities Prospective 

Payment System—Rate Update; 

Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule published in the Federal 

Register on August 2, 2023 entitled 

‘‘Medicare Program; FY 2024 Inpatient 

Psychiatric Facilities Prospective 

Payment System—Rate Update’’. 

DATES: This correction is effective 

October 1, 2023. 

FOR FURTHER INFORMATION CONTACT: The 

IPF Payment Policy mailbox at 

IPFPaymentPolicy@cms.hhs.gov for 

information regarding the IPF wage 

index. 

Lauren Lowenstein-Turner, (410) 

786–4507, for information regarding the 

inpatient psychiatric facilities quality 

reporting program. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2023–16083 of August 2, 

2023, the fiscal year (FY) 2024 Inpatient 

Psychiatric Facilities Prospective 

Payment System (IPF PPS) final rule (88 

FR 51054), there were technical errors 

that are identified and corrected in this 

correcting document. These corrections 

are effective as if they had been 

included in the FY 2024 IPF PPS final 

rule. Accordingly, the corrections are 

effective October 1, 2023. 

II. Summary of Errors 

On page 51115, in the first line of the 

first column, we omitted a link after the 

phrase ‘‘available at.’’ 

On page 51122, in the first paragraph 

of the first column, we omitted a link 

after the phrase ‘‘we refer readers to the 

description of the survey in the Journal 

of Patient Experience:’’. 

On page 51122, in item (4) in the last 

paragraph of the second column, there 

is an extra ‘‘of’’. 

On page 51129, in footnote 218, the 

link is incorrect. 

On page 51129, in footnote 219, the 

link is incorrect. 

On page 51129, in footnote 223, we 

omitted a link after ‘‘. . . Bivalent 

Vaccine Boosters.’’. 

On page 51136, in the first partial 

paragraph of the third column, we 

incorrectly included the phrase ‘‘and 

patient.’’ 

On page 51136, in the first full 

paragraph of the third column, we 

incorrectly included the phrase ‘‘prior 


lotter on DSK11XQN23PROD with RULES1