80098 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

2. On page 64672, in the first column, 

in the first full paragraph, in line 6, 

‘‘3.8’’ is corrected to read ‘‘3.9’’. 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22496 Filed 9–27–24; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 405, 412, 413, 431, 482, 

485, 495, and 512 

[CMS–1808–CN2] 

RIN 0938–AV34 

Medicare and Medicaid Programs and 

the Children’s Health Insurance 

Program; Hospital Inpatient 

Prospective Payment Systems for 

Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and Policy Changes 

and Fiscal Year 2025 Rates; Quality 

Programs Requirements; and Other 

Policy Changes; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services HHS. 

ACTION: Final rule; correction 

SUMMARY: This document corrects 

technical and typographical errors in 

the final rule that appeared in the 

August 28, 2024 Federal Register titled 

‘‘Medicare and Medicaid Programs and 

the Children’s Health Insurance 

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 

2025 Rates; Quality Programs 

Requirements; and Other Policy 

Changes’’ (referred to hereafter as the 

‘‘FY 2025 IPPS/LTCH PPS final rule’’). 

DATES: The corrections in this document 

are effective October 1, 2024. 

FOR FURTHER INFORMATION CONTACT: 

Donald Thompson and Michele 

Hudson, DAC@cms.hhs.gov, (410) 786– 

4487, IPPS Payment Rate Issues. 

Lily Yuan, NewTech@cms.hhs.gov, 

New Technology Add-On Payments 

Issues. 

Benjamin Cohen, benjamin.cohen@

cms.hhs.gov, Provider Reimbursement 

Review Board. 

Mady Hue, marilu.hue@cms.hhs.gov, 

and Andrea Hazeley, andrea.hazeley@

cms.hhs.gov, MS–DRG Classifications 

Issues. 

Jennifer Tate, jennifer.tate@

cms.hhs.gov, Hospital-Acquired 

Condition Reduction Program— 

Administration Issues. 

Julia Venanzi, julia.venanzi@

cms.hhs.gov, Hospital Inpatient Quality 

Reporting Program and Hospital ValueBased Purchasing Program— 

Administration Issues. 

Jennifer Tate, jennifer.tate@

cms.hhs.gov, PPS-Exempt Cancer 

Hospital Quality Reporting— 

Administration Issues. 

Ariel Cress, ariel.cress@cms.hhs.gov 

or Lorraine Wickiser, lorraine.wickiser@

cms.hhs.gov, Long-Term Care Hospital 

Quality Reporting Program— 

Administration Issues. 

Jessica Warren, jessica.warren@

cms.hhs.gov and Elizabeth Holland, 

elizabeth.holland@cms.hhs.gov, 

Medicare Promoting Interoperability 

Program. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2024–07567 of August 28, 

2024 (89 FR 68986), there were a 

number of typographical and technical 

errors that are identified and corrected 

in this correcting document. The 

corrections in this correcting document 

are applicable to discharges occurring 

on or after October 1, 2024, as if they 

had been included in the document that 

appeared in the August 28, 2024 

Federal Register. 

II. Summary of Errors 

A. Summary of Error in the Dates 

Section 

On page 68986, we are correcting 

technical errors in our discussion of the 

regulatory provisions that are effective 

November 1, 2024. 

B. Summary of Errors in the Preamble 

On pages 69060 and 69095, in our 

discussion of the Change to Specific 

Medicare Severity Diagnosis-Related 

Group (MS–DRG) Classifications, we are 

correcting several inadvertent 

typographical errors. 

Under our methodologies as finalized 

in the FY 2025 IPPS/LTCH PPS final 

rule, we exclude hospitals that have 

subsequently converted to rural 

emergency hospitals (REHs) from 

certain data and calculations used in the 

IPPS ratesetting. Specifically, we stated 

that we exclude REHs, including 

hospitals that subsequently became 

REHs after the period from which the 

data were taken for purposes of 

developing the MS–DRG relative 

weights for FY 2025 (89 FR 69109) and 

from the calculation of the standardized 

amount (89 FR 69942). In addition, we 

stated that any hospital that is 

designated as a REH by 7 days prior to 

the publication of the preliminary wage 

index public use file (PUF) is excluded 

from the calculation of the wage index. 

We inadvertently treated a current IPPS 

hospital as a hospital that had converted 

to REH status, thereby erroneously 

excluding its data from the MS–DRG 

relative weight calculation and the wage 

index (CMS Certification Number (CCN) 

260163). Therefore, we restored the 

applicable data for this hospital for 

these and other ratesetting calculations, 

as discussed further in section II.D. of 

this correcting document. 

We are correcting an error in the 

version 42 MS–DRG assignment for 

some cases in the historical claims data 

in the FY 2023 MedPAR files used in 

the ratesetting for the FY 2025 IPPS/ 

LTCH PPS final rule, which resulted in 

inadvertent errors in the MS–DRG 

relative weights. (We note this error did 

not change the associated average 

length-of-stay (LOS) for the impacted 

DRGs.) Additionally, the version 42 

MS–DRG assignment and relative 

weights are used when determining 

total payments for purposes of all of the 

budget neutrality factors and the final 

outlier threshold. Therefore, the 

corrections to the MS–DRG assignment 

under the version 42 GROUPER for 

some cases in the historical claims data 

in the FY 2023 MedPAR files (along 

with the restoration of the data for CCN 

260163 as discussed previously) and the 

conforming recalculation of the relative 

weights directly affected the calculation 

of total payments and required the 

recalculation of all the budget neutrality 

factors and the final outlier threshold. 

On page 69109, we are correcting the 

number of Medicare discharges from 

IPPS providers in the FY 2023 MedPAR 

file used in calculating the relative 

weights for FY 2025 due to the 

correction of the number of hospitals 

with REH status. 

On page 69113, we are correcting the 

normalization adjustment factor used in 

calculating the relative weights for FY 

2025 due to the correction of the 

number of hospitals with REH status, 

the error in the version 42 MS–DRG 

assignment for some cases in the 

historical claims data, and the 

conforming changes to the relative 

weights. 

On page 69268, we are correcting the 

total number of hospitals that were 

removed from the FY 2025 IPPS wage 

index due to conversion to REH status 

and making a corresponding correction 

to the number of hospitals’ wage data 

used to calculate the FY 2025 wage 

index. 


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On page 69277, we are correcting the 

occupational mix adjusted national 

average hourly wage due to the 

inadvertent omission of one hospital’s 

wage data (CCN 260163). (We note, 

there was no change to the unadjusted 

national average hourly wage value 

rounded to 2-digits.) 

On page 69282 in the discussion of 

the FY 2025 reclassification application 

requirements and approvals, due to 

reclassification errors described in 

section II.D. of this correcting 

document, we are correcting the number 

of hospitals approved for 

reclassification in FY 2025, the total 

number of hospitals in reclassification 

status, and the number of hospitals 

reclassified back to their geographic 

urban area. 

On page 69282, in the discussion of 

the FY 2025 reclassification application 

requirements and approvals, we are 

correcting a typographical error in the 

date applications for FY 2026 

reclassifications are due to the Medicare 

Geographic Classification Review Board 

(MGCRB). 

On page 69291, we inadvertently 

omitted a hospital from the list of all 

hospitals subject to our reclassification 

assignment and reassignment policy for 

core-based statistical areas (CBSAs) 

reconfigured due to the migration to 

Connecticut planning regions and the 

CBSA assigned or reassigned for FY 

2025 under this policy. We are 

correcting this error by adding a 

hospital, CCN 220015 to Table Y 

‘‘HOSPITALS SUBJECT TO 

RECLASSIFICATION ASSIGNMENT 

POLICY’’. The assignment of the 

hospital’s MGCRB reclassification is 

discussed further in section II.D. of this 

correcting document. 

On page 69308, because we restored 

the wage data for a IPPS hospital that 

we inadvertently treated as a REH and 

recalculated the wage index (as 

discussed earlier in this section) and 

made corrections to the MGCRB 

reclassification status of three hospitals 

(as discussed in section II.D. of this 

correcting document), we recalculated 

budget neutrality factors, including the 

rural floor budget neutrality factor, 

which is the only budget neutrality 

factor applied to the FY 2025 wage 

indexes (as discussed in section II.D. of 

this correcting document), made 

conforming changes to the out-migration 

adjustment discussed in section II.E. of 

this correcting document (as discussed 

with regard to Table 4A in section II.E. 

of this correcting document) and made 

a conforming change to the 25th 

percentile wage index value across all 

hospitals. 

On pages 69313 and 69315, we are 

correcting typographical errors in the 

number of hospitals that may participate 

in the Rural Community Hospital 

Demonstration Program at the start of 

FY 2025. 

On page 69369, we inadvertently 

omitted a reference to population health 

professional shortage areas (HPSAs) 

when summarizing the prioritization 

methodology for the distribution any 

remaining slots after awarding up to 

1.00 FTE to each qualifying hospital 

under section 4122 of the Consolidated 

Appropriations Act, 2023. 

On page 69400, in our discussion of 

the Hospital Readmissions Reduction 

Program, we are correcting a 

typographical error. 

On pages 69455, 69458, 69463, 69476, 

69481, 69489, 69529, 69533, 69534, 

69538, 69540, 69544, 69545, 69549, 

69572, 69573, and 69575 in our 

discussion of the Hospital Inpatient 

Quality Reporting Program, we are 

correcting several typographical and 

technical errors. 

On page 69503, in our discussion of 

the Modifications to the Hospital 

Consumer Assessment of Healthcare 

Providers and Systems (HCAHPS) 

Survey measure, we are correcting a 

typographical error. 

On page 69512, in our discussion of 

the Advancing Patient Safety and 

Outcomes Across the Hospital Quality 

Programs—Request for Comment, we 

are correcting a technical error. 

On pages 69577 and 69578, in our 

discussion of the PPS-Exempt Cancer 

Hospital Quality Reporting (PCHQR) 

Program, we are correcting 

typographical errors. 

On pages 69590, in our discussion of 

the Long-term Care Quality Reporting 

Program (LTCH QRP), we are correcting 

a typographical error. 

On pages 69605 through 69613, 

69621, and 69622 in our discussion of 

the Medicare Promoting Interoperability 

Program, we are correcting several 

typographical and technical errors. 

On page 69880, in our discussion of 

the Provider Reimbursement Review 

Board, we are correcting an inadvertent 

grammatical error. 

On pages 69901 and 66902, in our 

discussion of the information collection 

requirements for the LTCH QRP, we are 

correcting typographical errors. 

C. Summary of Errors in the Regulations 

Text 

On page 69914, in the regulations text 

for the Medicare Promoting 

Interoperability Program at 

§ 495.24(f)(1)(i)(C), we are correcting a 

technical error. 

D. Summary of Errors in the Addendum 

We made inadvertent errors in the 

Medicare Geographic Classification 

Review Board (MGCRB) reclassification 

status of 3 hospitals in the FY 2025 

IPPS/LTCH PPS final rule. Specifically, 

we are correcting the MGCRB 

reclassification for CCNs 170040 and 

220015. The correct reclassified CBSA 

for CCN 170040 is 41440, and the 

correct reclassified CBSA for CCN 

220015 is 49340. We are also adding an 

MGCRB reclassification for CCN 520034 

to CBSA 43100. The final FY 2025 IPPS 

wage index with reclassification is used 

when determining total payments for 

purposes of all budget neutrality factors 

(except for the MS–DRG reclassification 

and recalibration budget neutrality 

factor before the cap, MS–DRG 

reclassification and recalibration budget 

neutrality factor with the cap and the 

wage index budget neutrality 

adjustment factor) and the final outlier 

threshold. 

In addition, as discussed in section 

II.B. of this correcting document, we 

inadvertently treated a current IPPS 

hospital as a hospital that had converted 

to REH status, thereby erroneously 

excluding its data from the IPPS 

ratesetting calculations for FY 2025, 

including the standardized amount 

calculations. After restoring the 

hospital’s data (CCN 260163) and 

correcting the version 42 MS–DRG 

assignment for some cases in the 

historical claims data (as also discussed 

in section II.B. of this correcting 

document, we recalculated the MS–DRG 

relative weights, all wage indexes (and 

geographic adjustment factors (GAFs)), 

all budget neutrality factors, the fixedloss cost threshold, and the national 

operating standardized amounts and 

capital Federal rate. The MGCRB 

reclassification changes described 

previously were included in these 

recalculations as applicable. 

Due to the errors described 

previously, we made updates to the 

calculation of Factor 3 of the 

uncompensated care payment 

methodology to reflect the updated 

information for the IPPS hospital that 

had inadvertently been treated as a 

hospital that had converted to an REH. 

This hospital is projected to be DSHeligible for purposes of interim 

uncompensated care payments during 

FY 2025. We recalculated the total 

uncompensated care amount for all 

DSH-eligible hospitals to reflect these 

updates. In addition, because the Factor 

3 for each hospital reflects that 

hospital’s uncompensated care amount 

relative to the uncompensated care 

amount for all subsection (d) hospitals 


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that receive a DSH payment for the 

fiscal year, we also recalculated Factor 

3 for all DSH-eligible hospitals. The 

hospital-specific Factor 3 determines 

the total amount of the uncompensated 

care payment a hospital is eligible to 

receive for a fiscal year. This hospitalspecific payment amount is then used to 

calculate the amount of the interim 

uncompensated care payments a 

hospital receives per discharge. Given 

the very narrowly targeted update to the 

information used in the calculation of 

Factor 3, the change to the previously 

calculated Factor 3 for the majority of 

hospitals is of limited magnitude. We 

incorporated the revised 

uncompensated care payment amounts 

for all DSH-eligible hospitals into our 

recalculation of the FY 2025 fixed-loss 

threshold and related budget neutrality 

figures. 

On page 69960, we made conforming 

changes to the operating national 

average case-weighted cost-to-charge 

ratios (CCRs) for March 2023 and March 

2024, the 1-year national operating CCR 

adjustment factor, the capital national 

average case-weighted CCRs for March 

2023 and March 2024, and the 1-year 

national capital CCR adjustment factor 

to reflect the inclusion of applicable 

data for the IPPS hospital that had 

inadvertently been treated as a hospital 

that converted to an REH. 

Due to the correction of the 

combination of errors that are discussed 

previously, we made changes to the 

following: 

• On page 69948, the table titled 

‘‘Summary of FY 2025 Budget 

Neutrality Factors’’. 

• On page 69955, estimated capital 

outlier payments and estimated total 

capital Federal payments. 

• On page 69961, the outlier fixedloss cost threshold, total operating 

Federal payments, total operating 

outlier payments, and the outlier 

adjustment to the capital Federal rate. 

• On page 69963, the table titled 

‘‘Changes from FY 2024 Standardized 

Amounts to the FY 2025 Standardized 

Amounts’’. 

In determining the capital budget 

neutrality adjustment factor for changes 

in DRG classifications and weights and 

the GAF, under our 2-step calculation of 

the GAF budget neutrality factor, we 

inadvertently assigned one hospital the 

incorrect FY 2024 GAF without 

incorporating the lowest quartile 

hospital wage index adjustment and the 

5 percent cap on wage index decreases. 

We recalculated the capital outlier 

adjustment factor, the GAF/DRG budget 

neutrality factor, and the Quartile/Cap 

budget neutrality factor to reflect the 

correction of one hospital’s FY 2024 

GAF. We note that these recalculations 

also reflect the correction of the error in 

the REH status, the correction of the 

error in the version 42 MS DRG 

assignment for some cases in the 

historical claims data, the recalculation 

of the relative weights, and the 

correction of the MGCRB 

reclassification status for certain 

hospitals described previously. As we 

noted in the final rule, the capital 

Federal rate is calculated using 

unrounded budget neutrality and outlier 

adjustment factors. The unrounded 

Quartile/Cap budget neutrality factor 

and the unrounded outlier adjustment 

to the capital Federal rate were revised 

because of these errors. However, after 

rounding these factors to 4 decimal 

places as displayed in the final rule, the 

rounded factors were unchanged from 

the final rule. 

On pages 69966 through 69971, in the 

discussion of the determination of the 

Federal hospital inpatient capital 

related prospective payment rate 

update, due to the correction of these 

errors as discussed previously, we made 

conforming corrections to the GAF/DRG 

budget neutrality factor, the capital 

Federal rate, and related figures. As a 

result of these changes, we also made 

conforming corrections in the table 

showing the comparison of factors and 

adjustments for the FY 2024 capital 

Federal rate and FY 2025 capital Federal 

rate. 

On page 69987, we are making 

conforming changes to the applicable 

HCO threshold for site neutral payment 

rate cases under the LTCH PPS for FY 

2025 since it is calculated as the sum of 

the site neutral payment rate for the case 

and the IPPS fixed-loss amount. 

On page 69990, we are making 

conforming corrections to the national 

adjusted operating standardized 

amounts and capital standard Federal 

payment rate (which also include the 

rates payable to hospitals located in 

Puerto Rico) in Tables 1A, 1B, 1C, and 

1D as a result of the conforming 

corrections to certain budget neutrality 

factors, as previously described. 

E. Summary of Errors in the Appendices 

On pages 69994, 69996 through 

70001, 70003 through 70004, 70006 

through 70008, and 70030 through 

70032, in the regulatory impact 

analyses, we have made conforming 

corrections to the factors, values, and 

tables, and the accompanying 

discussion of the changes to operating 

and capital IPPS payments for FY 2025 

as a result of the technical errors that 

lead to changes in our calculation of 

certain IPPS budget neutrality factors, 

MS–DRG relative weights, wage 

indexes, and other figures as described 

in sections II.B. and D. of this correcting 

document. These conforming 

corrections include changes to the 

following: 

• On pages 69998 through 70000, the 

table titled ‘‘Table I—Impact Analysis of 

Changes to the IPPS for Operating Costs 

for FY 2025’’. 

• On pages 70003 and 70004, the 

table titled ‘‘Table II—Impact Analysis 

of Changes for FY 2025 Acute Care 

Hospital Operating Prospective Payment 

System (Payments per Discharge)’’. 

• On pages 70007 and 70008, the 

table titled ‘‘Table III—Provider Deciles 

by Beneficiary Characteristics’’. 

• On pages 70031 through 70032, the 

table titled ‘‘Table III—Comparison of 

Total Payments per Case’’. 

On page 70011, in our discussion of 

the effects of the changes to new 

technology add-on payments, we are 

correcting inadvertent typographical 

errors made in the numbers of 

traditional pathway technologies and 

new technology add-on payments 

provided for those technologies in FY 

2025. 

On pages 70012 through 70015, we 

are correcting the discussion of the 

‘‘Medicare DSH Uncompensated Care 

Payments and Supplemental Payment 

for Indian Health Service Hospitals and 

Tribal Hospitals and Hospitals Located 

in Puerto Rico’’ for purposes of the 

Regulatory Impact Analysis in 

Appendix A of the FY 2025 IPPS/LTCH 

PPS final rule, including the table titled 

‘‘Modeled Uncompensated Care 

Payments* and Supplemental Payments 

for Estimated FY 2025 DSHs by Hospital 

Type,’’ in light of the corrections 

discussed in section II.D. of this 

correcting document. 

On page 70022, in our discussion of 

the effects of the changes to the Hospital 

VBP Program, we are correcting 

technical errors the entries for ‘‘By MCR 

Percent’’, ‘‘By DSH Percent’’, and By 

Teaching Status’’ in Table I.8–01. 

F. Summary of Errors in and Corrections 

to Files and Tables Posted on the CMS 

Website 

We are correcting the errors in the 

following IPPS tables that are listed on 

page 69989 of the FY 2025 IPPS/LTCH 

PPS final rule and are available on the 

internet on the CMS website at https:// 

www.cms.gov/Medicare/MedicareFeefor-ServicePayment/Acute

InpatientPPS/index.html. The tables 

that are available on the internet have 

been updated to reflect the revisions 

discussed in this final rule correction. 

Table 2.—Final Case-Mix Index and 

Wage Index Table by CCN—FY 2025 

Final Rule. As discussed in the previous 


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section, we inadvertently treated a 

current IPPS hospital as a hospital that 

had converted to REH status, thereby 

erroneously excluding its data from the 

wage index (CCN 260163). Therefore, 

we restored this provider to Table 2, 

which includes all relevant values for 

this provider for each column in the 

table. (We note, CCN 260163 has a 

MGCRB reclassification to CBSA 14.) 

Because of the inadvertent errors in 

the MGCRB reclassification status of 3 

hospitals (as discussed in section II.D. of 

this correcting document) we are 

making the following corrections in 

Table 2: We are correcting the values in 

the columns titled ‘‘Wage Index 

Payment CBSA’’ and ‘‘MGCRB Reclass’’ 

for CCNs 170040, 220015 and 520034. 

As mentioned earlier, the correct 

reclassified CBSA for CCN 170040 is 

41440, and the correct reclassified 

CBSA for CCN 220015 is 49340. The 

‘‘Y’’ value in the column titled ‘‘MGCRB 

Reclass to Home’’ for both CCNs has 

also been removed, as the correct 

MGCRB reclassification CBSA is not the 

hospitals’ geographic urban CBSA. We 

are also adding an MGCRB 

reclassification for CCN 520034 by 

inserting CBSA 43100 to the columns 

‘‘Wage Index Payment CBSA’’ and 

‘‘MGCRB Reclass’’. 

Due to the inadvertent omission of 

one hospital’s wage data (CCN 260163), 

we are correcting the occupational mix 

adjusted national average hourly wage 

(as discussed in section II.B. of this 

correcting document), and we 

recalculated all of the budget neutrality 

adjustments (as discussed in section 

II.D. of this correcting document) 

including the recalculation of the rural 

floor budget neutrality factor, which is 

the only budget neutrality factor applied 

to the FY 2025 wage indexes. As 

discussed in section II.D. of this 

correcting document we are making 

corrections to the MGCRB 

reclassification status of three hospitals. 

Because all these changes affect the 

calculation of various area wage indexes 

used to determine certain budget 

neutrality factors and hospitals’ final 

wage index value for FY 2025, we are 

also making conforming changes to the 

other impacted wage indexes, including 

the imputed floor, outmigration 

adjustment (as discussed later in this 

section) and the 25th percentile wage 

index value across all hospitals (as 

discussed in section II.D. of this 

correcting document). Therefore, based 

on all these changes described 

previously, we are correcting the values 

in the columns titled ‘‘FY 2025 Wage 

Index Prior to Quartile and Cap’’, ‘‘FY 

2025 Wage Index With Quartile’’, ‘‘FY 

2025 Wage Index With Quartile and 

Cap’’, and ‘‘Out-Migration Adjustment’’. 

We also updated footnote number 6 to 

reflect the conforming change to the 

25th percentile wage index value across 

all hospitals. 

Table 3.—Final Wage Index Table by 

CBSA—FY 2025 Final Rule. As 

discussed previously, we inadvertently 

treated a current IPPS hospital as a 

hospital that had converted to REH 

status, thereby erroneously excluding its 

data from the wage index (CCN 260163). 

Therefore, we restored CCN 260163 to 

the wage data and recalculated the FY 

2025 wage index for CBSA 26 as well 

as the reclassified wage index for CBSA 

14 (see discussion earlier in this section 

regarding the MGCRB reclassification 

for CCN 260163). We also revised the 

values in the columns titled ‘‘FY 2025 

Average Hourly Wage’’ and ‘‘3-Year 

Average Hourly Wage (2023, 2024, 

2025)’’ for CBSA 26. 

Because of the inadvertent errors in 

the MGCRB reclassification status of 

CCNs 170040, 220015 and 520034 (as 

discussed earlier in this section), we 

recalculated the wage index for CBSAs 

41440, 49340, 43100, and the rural wage 

index for Wisconsin (CBSA 52). 

Due to the inadvertent omission of 

one hospital’s wage data (CCN 260163), 

we are correcting the occupational mix 

adjusted national average hourly wage 

(as discussed in section II.B. of this 

correcting document), and we 

recalculated all of the budget neutrality 

adjustments (as discussed in section 

II.D. of this correcting document), 

including the recalculation of the rural 

floor budget neutrality factor, which is 

the only budget neutrality factor applied 

to the FY 2025 wage indexes. As 

discussed earlier in this section we 

made corrections to the MGCRB 

reclassification status of three hospitals. 

Because these changes described earlier 

(restoring provider 2060163 to the wage 

data, the inadvertent errors in the 

MGCRB reclassification status of CCNs 

170040, 220015 and 520034, the 

recalculation of the rural floor budget 

neutrality factor) affect the area pre and 

post reclassified wage indexes, we are 

also making conforming changes to the 

other impacted wage indexes, including 

the imputed floor. We also are making 

corresponding changes to the GAFs for 

any CBSAs with a wage index that 

changed. Based on all these changes 

described previously, we are correcting 

the values and flags in the columns 

titled ‘‘Wage Index’’, ‘‘GAF’’, 

‘‘Reclassified Wage Index’’, 

‘‘Reclassified GAF’’, ‘‘State Rural 

Floor’’, ‘‘Eligible for Rural Floor Wage 

Index’’, ‘‘Pre-Frontier and/or Pre-Rural 

Floor Wage Index’’, ‘‘Reclassified Wage 

Index Eligible for Frontier Wage Index’’, 

‘‘Reclassified Wage Index Eligible for 

Rural Floor Wage Index’’, and 

‘‘Reclassified Wage Index Pre-Frontier 

and/or Pre-Rural Floor’’. 

Table 4A.—Final List of Counties 

Eligible for the Out-Migration 

Adjustment under Section 1886(d)(13) 

of the Act—FY 2025 Final Rule. Due to 

the inadvertent omission of one 

hospital’s wage data (CCN 260163), we 

are correcting the occupational mix 

adjusted national average hourly wage 

(as discussed in section II.B. of this 

correcting document), and we 

recalculated all of the budget neutrality 

adjustments (as discussed in section 

II.D. of this correcting document) 

including the recalculation of the rural 

floor budget neutrality factor, which is 

the only budget neutrality factor applied 

to the FY 2025 wage indexes. As also 

discussed in section II.D. of this 

correcting document and earlier in this 

section, we made corrections to the 

MGCRB reclassification status of three 

hospitals. Because all these changes 

affect various area wage indexes 

(including the post reclassified wage 

indexes), we are also making 

conforming changes to the other 

impacted wage indexes, including the 

imputed floor. As discussed in the FY 

2012 IPPS final rule (76 FR 51601 

through 51602), we calculate the outmigration adjustment using the postreclassified wage indexes. Because the 

wage indexes are one of the inputs used 

to determine the out-migration 

adjustment, the out-migration 

adjustments for some counties/hospitals 

changed. Therefore, we are making 

corresponding changes to certain outmigration adjustments listed in Table 

4A. Specifically, we are correcting the 

values in the column titled ‘‘FY 2025 

Out-Migration Adjustment’’. 

Table 5.—Final List of Medicare 

Severity Diagnosis-Related Groups (MS– 

DRGs), Relative Weighting Factors, and 

Geometric and Arithmetic Mean Length 

of Stay—FY 2025 Final Rule. We are 

correcting this table to reflect the 

recalculation of the relative weights, 

geometric average length-of-stay (LOS), 

and arithmetic mean LOS as a result of 

the correction of the number of 

hospitals with REH status and the 

correction in the version 42 MS–DRG 

assignment for some cases in the 

historical claims data (as discussed in 

section II.B. of this correcting 

document). 

Table 12B.—Final LTCH PPS Wage 

Index for Rural Areas for Discharges 

Occurring from October 1, 2024, 

through September 30, 2025. As 

discussed in the previous section, we 

inadvertently excluded a hospital (CCN 

260163) from the IPPS wage data used 


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to calculate the FY 2025 LTCH PPS 

wage index. This resulted in a 

correction to the wage index value for 

rural Missouri (CBSA 26) in Table 12B. 

(We note, there are no LTCHs located in 

rural Missouri in the data used to 

develop the FY 2025 LTCH PPS rates in 

the FY 2025 IPPS/LTCH PPS final. 

Therefore, this correction to the LTCH 

PPS wage index value for rural Missouri 

did not necessitate the recalculation of 

the FY 2025 LTCH PPS rates.) 

Table 18.—Final FY 2025 Medicare 

DSH Uncompensated Care Payment 

Factor 3. We further note that we also 

made updates to the calculation of 

Factor 3 of the uncompensated care 

payment methodology to reflect the 

updated information for the IPPS 

hospital that had inadvertently been 

treated as a hospital that had converted 

to an REH. This hospital is projected to 

be DSH-eligible for purposes of the 

interim uncompensated care payments 

during FY 2025, but its data was 

erroneously excluded from the Factor 3 

calculations for FY 2025. We 

recalculated the total uncompensated 

care amount for all DSH-eligible 

hospitals to reflect this update. In 

addition, because the Factor 3 

calculated for each hospital reflects that 

hospital’s uncompensated care amount 

relative to the uncompensated care 

amount for all subsection (d) hospitals 

that receive a DSH payment for the 

fiscal year, we also recalculated Factor 

3 for all DSH-eligible hospitals. The 

hospital-specific Factor 3 determines 

the total amount of the uncompensated 

care payment a hospital is eligible to 

receive for the fiscal year. This hospitalspecific payment amount is then used to 

calculate the amount of the interim 

uncompensated care payments a 

hospital receives per discharge. Given 

the very narrowly targeted update to the 

information used in the calculation of 

Factor 3, the change to the previously 

calculated Factor 3 is of limited 

magnitude for the majority of hospitals. 

For the FY 2025 IPPS/LTCH PPS final 

rule, we published a list of hospitals 

that we identified to be subsection (d) 

hospitals and subsection (d) Puerto Rico 

hospitals projected to be eligible to 

receive interim uncompensated care 

payments for FY 2025. We are updating 

this list and the calculation of Factor 3 

of the uncompensated care payment 

methodology to reflect the updated 

information for the IPPS hospital that 

was inadvertently treated as a hospital 

that had converted to an REH. We are 

revising Factor 3 for all hospitals to 

reflect this correction. We are also 

revising the amount of the total 

uncompensated care payment 

calculated for each DSH-eligible 

hospital. The total uncompensated care 

payment that a hospital receives is used 

to calculate the amount of the interim 

uncompensated care payments the 

hospital receives per discharge. 

III. Waiver of Proposed Rulemaking 

and Delay in Effective Date 

Under 5 U.S.C. 553(b) of the 

Administrative Procedure Act (APA), 

the agency is required to publish a 

notice of the proposed rulemaking in 

the Federal Register before the 

provisions of a rule take effect. 

Similarly, section 1871(b)(1) of the Act 

requires the Secretary to provide for 

notice of the proposed rulemaking 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 notice 

and comment and delay in effective date 

APA 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 rulemaking requirements for 

good cause if the agency makes a 

finding that the notice and comment 

process are impracticable, unnecessary, 

or contrary to the public interest. In 

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

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

Act allow the agency to avoid the 30- 

day delay in effective date where such 

delay is contrary to the public interest 

and an agency includes a statement of 

support. 

We believe that this final rule 

correction does not constitute a rule that 

would be subject to the notice and 

comment or delayed effective date 

requirements. This document corrects 

technical and typographical errors in 

the preamble, regulations text, 

addendum, tables, and appendices 

included or referenced in the FY 2025 

IPPS/LTCH PPS final rule but does not 

make substantive changes to the policies 

or payment methodologies that were 

adopted in the final rule. As a result, 

this final rule correction is intended to 

ensure that the information in the FY 

2025 IPPS/LTCH PPS final rule 

accurately reflects the policies adopted 

in that document. 

In addition, even if this were a rule to 

which the notice and comment 

procedures 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 final rule or delaying 

the effective date would be contrary to 

the public interest because it is in the 

public’s interest for providers to receive 

appropriate payments in as timely a 

manner as possible, and to ensure that 

the FY 2025 IPPS/LTCH PPS final rule 

accurately reflects our policies. 

Furthermore, such procedures would be 

unnecessary, as we are not altering our 

payment methodologies or policies, but 

rather, we are simply implementing 

correctly the methodologies and policies 

that we previously proposed, requested 

comment on, and subsequently 

finalized. This final rule correction is 

intended solely to ensure that the FY 

2025 IPPS/LTCH PPS final rule 

accurately reflects these payment 

methodologies and policies. Therefore, 

we believe we have good cause to waive 

the notice and comment and effective 

date requirements. 

IV. Correction of Errors 

In FR Doc. 2024–07567 of August 28, 

2024 (89 FR 68986), we are making the 

following corrections: 

A. Correction of Errors in the Dates 

Section 

1. On page 68986, first column, DATES

section, lines 7 and 8, the phrase ‘‘The 

regulations at §§ 482.42(e) and 

485.640(d)’’ is corrected to read ‘‘The 

regulations at §§ 482.42(e) and (f) and 

485.640(d) and (e)’’. 

B. Corrections of Errors in the Preamble 

2. On page 69060, third column, first 

partial paragraph: 

a. Lines 22 through 26, the phrase 

‘‘MS–DRG 447 ‘Multiple Level Anterior 

and Posterior Spinal Fusion Except 

Cervical with MCC or Custom-Made 

Anatomically Designed Interbody 

Fusion Device’ ’’ is corrected to read 

‘‘MS–DRG 447 ‘Multiple Level Spinal 

Fusion Except Cervical with MCC or 

Custom-Made Anatomically Designed 

Interbody Fusion Device’ ’’. 

b. Lines 26 through 29, the phrase 

‘‘MS–DRG 448 ‘Multiple Level Anterior 

and Posterior Spinal Fusion Except 

Cervical without MCC’ ’’ is corrected to 

read, ‘‘MS–DRG 448 ‘Multiple Level 

Spinal Fusion Except Cervical without 

MCC’ ’’. 

3. On page 69095, bottom of page, 

second column, first partial paragraph, 

line 7, the date ‘‘June 5, 2025’’ is 

corrected to read ‘‘June 5, 2024’’. 


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4. On page 69109, first column, last 

paragraph, line 3, the figure ‘‘6,916,571’’ 

is corrected to read ‘‘6,916,748’’. 

5. On page 69113, third column, first 

full paragraph, line 17, the figure 

‘‘1.92336’’ is corrected to read as 

‘‘1.92331’’. 

6. On page 69268, third column, first 

partial paragraph: 

a. Line 14, the figure ‘‘4’’ is corrected 

to read ‘‘3’’, 

b. Line 20, the figure ‘‘19’’ is corrected 

to read ‘‘18’’, 

b. Line 25, the figure ‘‘3,074’’ is 

corrected to read ‘‘3,075’’. 

7. On page 69277, at the bottom of the 

page, in the untitled table, the figure 

‘‘$54.97’’ is corrected to read ‘‘$54.96’’. 

8. On page 69282: 

a. Second column, third paragraph: 

i. Line 9, the figure ‘‘470’’ is corrected 

to read ‘‘471’’, 

ii. Line 29, the figure ‘‘1,078’’ is 

corrected to read ‘‘1,079’’, and 

iii. Line 32, the figure ‘‘237’’ is 

corrected to read ‘‘235’’. 

b. Third column, second full 

paragraph, line 3, the phrase ‘‘by 

September 1, 2024.’’ is corrected to read, 

‘‘by September 3, 2024 (while 

applications are due not later than 13 

months prior to the start of the fiscal 

year for which reclassification is sought, 

usually by September 1, it has been the 

MGCRB’s practice to allow submission 

up to the first business day in 

September).’’ 

9. On page 69291, the Table Y 

‘‘HOSPITALS SUBJECT TO 

RECLASSIFICATION ASSIGNMENT 

POLICY’’ is corrected by adding the 

following entry after row 8 (CCN 

070036) and before row 9 (CCN 220020): 

CCN MGCRB case No. Approved CBSA Final rule CBSA 

220015 ....................................................................................................................... 25C0368 49340 49340 

10. On page 69308, third column, 

middle of the page, the untitled table is 

corrected to read as follows: 

FY 2025 25th Percentile Wage Index Value ....................................................................................................................................... 0.9009 

11. On page 69313, second column, 

first partial paragraph, line 13, the figure 

‘‘23’’ is corrected to read ‘‘22’’. 

12. On page 69315, third column, first 

full paragraph, line 1, the figure ‘‘23’’ is 

corrected to read ‘‘22’’. 

13. On page 69369, second column, 

fourth full paragraph, line 14, the phrase 

‘‘mental-health-only geographic’’ is 

corrected to read ‘‘mental-health-only 

population and geographic’’. 

14. On page 69400, second column, 

last partial paragraph, line 9, the phrase 

‘‘beneficiaries, ERRs, and aggregate’’ is 

corrected to read ‘‘beneficiaries, excess 

readmission ratios (ERRs), and 

aggregate’’. 

15. On page 69455, third column, 

third footnote paragraph (footnote 266), 

lines 4 and 5, the web address ‘‘https:// 

www.cdc.gov/hai/data/archive/2021- 

HAI-progress-report.html#2018’’ is 

corrected to read ‘‘https://

archive.cdc.gov/#/details?url=https://

www.cdc.gov/hai/data/archive/2021- 

HAI-progress-report.html’’. 

16. On page 69458, second column, 

second footnote paragraph (footnote 

297), lines 4 through 6, the web address 

‘‘https://qualitynet.gov/inpatient/iqr/ 

proposedmeasures’’ is corrected to 

‘‘https://qualitynet.cms.gov/inpatient/ 

iqr/proposedmeasures’’. 

17. On page 69463, lower half of the 

page, first column, first footnote 

paragraph (footnote 304), lines 3 

through 5, the web address ‘‘https://

qualitynet.gov/inpatient/iqr/proposed

measures’’ is corrected to ‘‘https://

qualitynet.cms.gov/inpatient/iqr/ 

proposedmeasures.’’ 

18. On page 69476, first column, third 

footnote paragraph (footnote 341), lines 

4 through 8, the web address https://

www.cdc.gov/healthcare-associatedinfections/?CDC_AAref_Val=https://

www.cdc.gov/hai/prevent/ 

infection%25C2%25

ADcontrol%25C2%25

AD.assessment%25C2%25ADtools.html 

is corrected to ‘‘https://www.cdc.gov/ 

infection-control/media/pdfs/IPCInstructions-508.pdf.’’ 

19. On page 69481, first and second 

columns, footnote paragraph (footnote 

366), last line and lines 1 and 2, the web 

address ‘‘https://mmshub.cms.gov/sites/ 

default/files/PSSMTEP-SummaryReport-202306.pdf’’ is corrected to 

‘‘https://mmshub.cms.gov/sites/default/ 

files/PSSM-TEP-Summary-Report202306.pdf.’’ 

20. On page 69489, in the first 

column; first footnote paragraph 

(footnote 394), lines 3 through 5, the 

web address ‘‘https://qualitynet.gov/ 

inpatient/iqr/proposedmeasures’’ is 

corrected to ‘‘https://qualitynet.cms.gov/ 

inpatient/iqr/proposedmeasures.’’ 

21. On page 69503, third column, 

second full paragraph, lines 15 through 

17, the web address, ‘‘https://

hcahpsonline.org/en/mode-patient-mixadj/#jan2023publiclyreported’’ is 

corrected to read, ‘‘https://

hcahpsonline.org/en/mode--patientmix-adj/#jan2023publiclyreported.’’ 

22. On page 69512, second column, 

first footnote paragraph (footnote 437), 

lines 1 through 4, ‘‘Medicare Hospital 

Quality Chartbook. National Rates over 

Time. Available at: https://

www.cmshospitalchartbook.com/ 

visualization/national-rates-over-time. 

Accessed March 12, 2024.’’ is corrected 

to read ‘‘MedPAC. (2019). Update: 

MedPAC’s evaluation of Medicare’s 

Hospital Readmission Reduction 

Program. Available at: https://

www.medpac.gov/update-medpac-sevaluation-of-medicare-s-hospitalreadmission-reduction-program/.’’ 

23. On page 69529, first column, 

second footnote paragraph (footnote 

531), lines 2 through 4, the footnote 

‘‘CDC. (2024). National and State 

Healthcare-associated Infections 

Progress Report. Available at: https://

www.cdc.gov/healthcare-associatedinfections/php/data/progressreport.html.’’ is corrected to read ‘‘CDC. 

(2022). Antibiotic Resistance & Patient 

Safety Portal: Catheter-Associated 

Urinary Tract Infections. Available at: 

https://arpsp.cdc.gov/profile/nhsn/ 

cauti.’’. 

24. On page 69533, first column, 

second full paragraph, lines 9 through 

17, the sentences ‘‘In CAUTI and 

CLABSI SIRs, risk adjustment is applied 

at the individual location level, 

resulting in a count of infection events 

(SIR numerator) and predicted number 

of infections (SIR denominator). The 

NHSN then aggregates location-specific 

results for all of a facility’s locations 

prior to calculating the SIR.’’ are 

corrected to read ‘‘The NHSN then 

aggregates location-specific results for 

all of a facility’s locations prior to 

calculating the SIR.’’ 

25. On page 69534, first column, 

second full paragraph, lines 18–21, the 


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sentence ‘‘This would also allow more 

direct comparison with the CAUTI-Onc 

and CLABSI-Onc measures used in the 

PCHQR Program.’’ is corrected to read 

‘‘The oncology-specific measures would 

also allow more direct comparison with 

the CAUTI and CLABSI measures used 

in the PCHQR Program.’’. 

26. On page 69538, first column, last 

paragraph, lines 6 through 12, the 

sentence ‘‘Hospitals must report on the 

following three eCQMs: (1) Hospital 

Harm—Severe Hypoglycemia eCQM; (2) 

Hospital Harm—Severe Hyperglycemia 

eCQM; and (3) Hospital Harm—OpioidRelated Adverse Events eCQM.’’ is 

corrected to read ‘‘Hospitals must report 

on the following three eCQMs: (1) the 

Safe Use of Opioids—Concurrent 

Prescribing eCQM; (2) the Cesarean 

Birth eCQM; and (3) the Severe 

Obstetric Complications eCQM.’’. 

27. On page 69540, first column, last 

paragraph, line 11, the reference 

‘‘section XXXX’’ is corrected to read 

‘‘section X.A.’’. 

28. On page 69544, third column, last 

paragraph, lines 6 through 12, the 

sentence ‘‘Hospitals must report the 

following three eCQMs: (1) Hospital 

Harm—Severe Hypoglycemia eCQM; (2) 

Hospital Harm—Severe Hyperglycemia 

eCQM; and (3) Hospital Harm—OpioidRelated Adverse Events eCQM.’’ is 

corrected to read ‘‘Hospitals must report 

the following three eCQMs: (1) the Safe 

Use of Opioids—Concurrent Prescribing 

eCQM; (2) the Cesarean Birth eCQM; 

and (3) the Severe Obstetric 

Complications eCQM.’’. 

29. On page 69545, third column, first 

partial paragraph, line 3, the reference 

‘‘section XXXX’’ is corrected to read 

‘‘section X.A.’’. 

30. On page 69549, first column, 

fourth full paragraph, lines 5 through 7, 

the web address ‘‘https://

qualitynet.cms.gov/inpatient/iqr/ 

measures’’ is corrected to read ‘‘https:// 

qualitynet.cms.gov/inpatient/ 

measures.’’ 

31. On page 69572, third column, last 

paragraph, line 25, the table reference 

‘‘Table IX.C.XXXX’’ is corrected to read 

‘‘Table IX.C.10.’’. 

32. On page 69573, top of the page: 

a. First column, first paragraph, line 1, 

the table reference ‘‘Table IX.C.XXXX’’ 

is corrected to read ‘‘Table IX.C.10.’’ 

b. In the table titled, ‘‘TABLE 

IX.C.X:XXX. NEWLY FINALIZED eCQM 

REPORTING AND SUBMISSION 

REQUIREMENTS FOR THE CY 2026 

REPORTING PERIOD/FY 2028 

PAYMENT DETERMINATION AND 

SUBSEQUENT YEARS’’, line 1, the 

table number ‘‘TABLE IX.C.XXXX’’ is 

corrected to read ‘‘TABLE IX.C.10.’’. 

33. On page 69575: 

a. Top third of the page, third column, 

first full paragraph, line 3, the reference 

‘‘Table IX.C.10.’’ is corrected to read 

‘‘Table IX.C.11.’’. 

b. Middle of the page, in the table 

titled, ‘‘TABLE IX.C.10. SUMMARY OF 

THE CURRENT AND NEWLY 

MODIFIED VALIDATION SCORING 

POLICIES’’, line 1, the table number 

‘‘TABLE IX.C.10’’ is corrected to read 

‘‘TABLE IX.C.11.’’. 

34. On page 69577, third column, last 

partial paragraph, the parenthetical 

reference ‘‘(86 FR 36341)’’ is corrected 

to read ‘‘(89 FR 36341)’’. 

35. On page 69578, first column, first 

partial paragraph, line 2, the 

parenthetical reference ‘‘(86 FR 36341)’’ 

is corrected to read ‘‘(89 FR 36341)’’. 

36. On page 69590, first column, first 

partial paragraph, line 6, the word 

‘‘effect’’ is corrected to read ‘‘effective’’. 

37. On pages 69605 and 69606 remove 

the undesignated table. 

38. On pages 69606 through 69613 

correct ‘‘TABLE IX.F.–01.: SUMMARY 

OF OBJECTIVES AND MEASURES FOR 

THE MEDICARE PROMOTING 

INTEROPERABILITY PROGRAM FOR 

THE EHR REPORTING PERIOD IN CY 

2025’’ to read as follows: 

BILLING CODE 4120–01–P 


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TABLE IX.F.-01.: SUMMARY OF OBJECTIVES AND MEASURES FOR THE MEDICARE PR

INTEROPERABILITY PROGRAM FOR THE EHR REPORTING PERIOD IN CY 20

Electronic I e-Prescribing: The number of prescriptions The number of new or Any eligible hospital or CAH that doe

Prescribing ( e- in the denominator generated changed prescriptions not have an internal pharmacy that can 

Prescribing) For at least one hospital and transmitted written for drugs accept electronic prescriptions, and 

discharge, medication orders electronically. requiring a prescription there are no pharmacies that accept 

for permissible prescriptions in order to be dispensed, electronic prescriptions within 10 mile

( for new and changed other than controlled at the start of their EHR reporting 

prescriptions) are transmitted substances for patients period. 

electronically using CEHRT. * discharged during the 

EHR reoorting oeriod. 

e-Prescribing I Query of Prescription Drug NIA (measure is YIN) NIA (measure is YIN) ( 1) Any eligible hospital or CAH that 

Monitoring Program (PDMP): does not have an internal pharmacy 

that can accept electronic prescription

For at least one Schedule II for controlled substances that include 

opioid or Schedule III or IV Schedule II, III and IV drugs and is n

drug electronically prescribed located within 10 miles of any 

using CEHRT during the EHR pharmacy that accepts electronic 

reporting period, the eligible prescriptions for controlled substance

hospital or CAH uses data from at the start of their EHR reporting 

CEHR T to conduct a query of a period. 

PDMP for prescription drug (2) Any eligible hospital or CAH that 

history. could not report on this measure in 

accordance with applicable law. 

Health Information I Support Electronic Referral Number of transitions of care Number of transitions of None 

Exchange (HIE)*** Loops by Sending Health and referrals in the care and referrals during 

Information: denominator where a the EHR reporting 

summary of care record was period for which the 

For at least one transition of created using CEHRT and eligible hospital or CAH 

care or referral, the eligible exchanged electronically. inpatient or emergency 

hospital or CAH that transitions department (Place of 

or refers its patient to another Service [POS] 21 or 23) 

setting of care or provider of was the transitioning or 

care: (1) Creates a summary of referring provider. 

care record using CEHRT; and 

(2) Electronically exchanges 

the summ of care record. 

HIE I Support Electronic Referral Number of electronic Number of electronic None 

Loops by Receiving and summary of care records in summary of care records Reconciling Health the denominator for which received using CEHRT 

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HIE 

Information: 

For at least one electronic 

summary of care record 

received using CEHRT for 

patient encounters during the 

EHR reporting period for 

which an eligible hospital or 

CAH was the receiving party of 

a transition of care or referral, 

or for patient encounters during 

the EHR reporting period in 

which the eligible hospital or 

CAH has never before 

encountered the patient, the eligible hospital or CAH 

conducts clinical information 

reconciliation for medication, 

medication allergy, and current 

roblem list using CEHRT. 

clinical information 

reconciliation is completed 

using CEHRT for the 

following three clinical 

information sets: (1) 

Medication - Review of the 

patient's medication, 

including the name, dosage, 

frequency, and route of each 

medication; (2) Medication 

!Allergy - Review of the 

patient's known medication 

allergies; and (3) Current 

Problem List - Review of 

lthe patient's current and 

active diagnoses. 

HIE Bi-Directional Exchange IN/A (measure is YIN) 

The eligible hospital or CAH 

must attest to the following: 

(1) Participating in an HIE in 

order to enable secure, bidirectional exchange of 

information to occur for all 

unique patients discharged 

from the eligible hospital or 

CAH inpatient or emergency department (POS 21 or 23), and 

all unique patient records 

stored or maintained in the 

EHR for these departments, 

during the EHR reporting 

period in accordance with 

applicable law and policy. 

(2) Participating in an HIE that 

is capable of exchanging 

information across a broad 

network of unaffiliated 

exchange partners including 

those using disparate EHRs, 

for patient encounters 

during the EHR 

reporting period for which an eligible hospital or CAH was the reconciling party of a 

transition of care or 

referral, and for patient 

encounters during the 

EHR reporting period in 

which the eligible hospital or CAH has never before 

encountered the patient. 

NIA (measure is YIN) INone 

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HIE 

and not engaging in 

exclusionary behavior when determining exchange 

partners. 

(3) Using the functions of 

CEHRT to support bidirectional exchange with an 

HIE. Enabling Exchange under the IN/ A (measure is YIN) 

Trusted Exchange Framework 

and Common Agreement 

(TEFCA) 

The eligible hospital or CAH 

must attest to the following: 

( 1) Participating as a signatory 

to a Framework Agreement (as 

that term is defined by the 

Common Agreement for 

Nationwide Health Information 

Interoperability as published in 

the Federal Register and on 

ONC's website) in good 

standing (that is, not 

suspended) and enabling secure, bi-directional exchange 

of information to occur, in 

production, for all unique patients discharged from the 

eligible hospital or CAH 

inpatient or emergency 

department (POS 21 or 23), and 

all unique patient records 

stored or maintained in the 

EHR for these departments, 

during the EHR reporting 

period in accordance with 

applicable law and policy. 

(2) Using the functions of 

CEHRT to support bidirectional exchange of patient 

information, in production, 

under this Framework 

Agreement. 

NIA (measure is YIN) INone 

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Provider to Patient Exchange Public Health and 

Clinical Data 

Exchange 

Provide Patients Electronic 

Access to Their Health 

Information: 

For at least one unique patient 

discharged from the eligible 

hospital or CAH inpatient or 

emergency department (POS 

21 or 23): 

(1) the patient (or patientauthorized representative) is 

provided timely access to view 

online, download, and transmit 

their health information; and 

(2) the eligible hospital or CAH 

ensures the patient's health 

information is available for the 

patient ( or patient-authorized 

representative) to access using 

any application of their choice 

that is configured to meet the 

technical specifications of the 

application programming 

interface (API) in the eligible 

hospital's or CAH's CEHRT. 

Immunization Registry 

Reporting: 

The eligible hospital or CAH is 

in active engagement with a 

public health agency (PHA) to 

submit immunization data and 

receive immunization forecasts 

and histories from the public 

health immunization registry or 

immunization information 

system (IIS). 

The number of patients in 

lthe denominator ( or patient 

authorized representatives) 

who are provided timely 

access to health information 

Ito view online, download 

and transmit to a third party and to access using an application of their choice 

lthat is configured to meet the 

technical specifications of 

lthe API in the eligible 

hospital's or CAH's 

CEHRT. 

IN/A (measure is YIN) 

The number of unique 

patients discharged from 

an eligible hospital or 

CAR inpatient or 

emergency department (POS 21 or 23) during 

the EHR reporting 

period. 

NIA (measure is YIN) 

None 

Any eligible hospital or CAH meeting 

one or more of the following criteria 

may be excluded from the 

immunization registry reporting 

measure if the eligible hospital or 

CAH: (I) Does not administer any 

immunizations to any of the 

populations for which data are collect

by its jurisdiction's immunization 

registry or IIS during the EHR reporting period; (2) Operates in a 

jurisdiction for which no immunizatio

registry or IIS is capable of accepting 

the specific standards required to meethe CEHRT defmition at the start of th

EHR reporting period; or (3) Operates 

in a jurisdiction where no immunizatio

registry or IIS has declared readiness t

receive immunization data as of 6 

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months prior to the start of the EHR reoorting oeriod. 

Public Health and Syndromic Surveillance NIA (measure is YIN) NIA (measure is YIN) Any eligible hospital or CAH meeting 

Clinical Data Reporting: one or more of the following criteria 

Exchange may be excluded from the syndromic 

The eligible hospital or CAH is surveillance reporting measure if the 

in active engagement with a eligible hospital or CAH: (1) Does not 

PHA to submit syndromic have an emergency department; (2) 

surveillance data from an Operates in a jurisdiction for which no 

emergency department (POS PHA is capable ofreceiving electronic 

23). syndromic surveillance data from 

eligible hospitals or CAHs in the 

specific standards required to meet the 

CEHRT definition at the start of the 

EHR reporting period; or (3) Operates 

in a jurisdiction where no PHA has declared readiness to receive syndrom

surveillance data from eligible hospita

or CAHs as of 6 months prior to the 

start of the EHR reporting period. 

Public Health and Electronic Case Reporting NIA (measure is YIN) NIA (measure is YIN) Any eligible hospital or CAH meeting 

Clinical Data (eCR): one or more of the following criteria 

Exchange may be excluded from the case 

The eligible hospital or CAH is reporting measure if the eligible 

in active engagement with a hospital or CAH: (1) Does not treat or 

PHA to submit case reporting diagnose any reportable diseases for 

of reportable conditions. which data are collected by its 

jurisdiction's reportable disease system 

during the EHR reporting period; (2) 

Operates in a jurisdiction for which no 

PHA is capable ofreceiving eCR data 

in the specific standards required to 

meet the CEHRT definition at the star

of the EHR reporting period; or (3) 

Operates in a jurisdiction where no 

PHA has declared readiness to receive 

eCR data as of 6 months prior to the 

start of the EHR reporting period. 

Public Health and Electronic Reportable NIA (measure is YIN) NIA (measure is YIN) Any eligible hospital or CAH meeting 

Clinical Data Laboratory (ELR) Result one or more of the following criteria 

Exchange Reporting: may be excluded from the ELR result 

measure if the eligible hospital or 

The eligible hospital or CAH is CAH: (1) Does not perform or order 

in active engagement with a laboratory tests that are reportable in i

PHA to submit ELR results. iurisdiction during the EHR reoortin 

ER02OC24.005</GPH>lotter on DSK11XQN23PROD with RULES1

Public Health and 

Clinical Data 

Exchange 

Public Health and 

Clinical Data 

Exchange 

Public Health and 

Clinical Data 

Exchange 

Public Health and 

Clinical Data 

Exchange 

AU Surveillance**: 

The eligible hospital or CAR is 

in active engagement with 

CDC's NHSN to submit AU 

data for the EHR reporting 

period and receives a report 

from NHSN indicating its 

successful submission of AU 

data for the EHR reporting 

period.** 

AR Surveillance**: 

The eligible hospital or CAR is 

in active engagement with 

CDC's NHSN to submit AR 

data for the EHR reporting 

period and receives a report 

from NHSN indicating its 

successful submission of AR 

data for the EHR reporting 

period.** 

Public Health Registry 

Reporting: 

The eligible hospital or CAR is 

in active engagement with a 

PHA to submit data to public 

health registries. 

Clinical Data Registry 

Reporting: 

NIA (measure is YIN)** 

NIA (measure is YIN)** 

NIA (measure is YIN) NIA (measure is YIN) 

period; (2) Operates in a jurisdiction f

which no PHA is capable of accepting 

the specific ELR standards required to 

meet the CEHRT definition at the star

of the EHR reporting period; or (3) 

Operates in a jurisdiction where no 

PHA has declared readiness to receive ELR results from an eligible hospital o

CAR as of 6 months prior to the start 

the EHR reporting period. 

NIA (measure is YIN)** I Any eligible hospital or CAR may be 

excluded from the measure if the 

eligible hospital or CAR: (1) Does no

have any patients in any patient care 

location for which data are collected b

NHSN during the EHR reporting 

period; (2) Does not have 

eMAR/BCMA electronic records or a

ADT system during the EHR reporting 

period; or (3) Does not have a data 

source containing the minimal discrete 

data elements that are required for 

reporting.** 

NIA (measure is YIN)** I Any eligible hospital or CAR may be 

excluded from the measure if the 

eligible hospital or CAR: (1) Does no

have any patients in any patient care 

location for which data are collected b

NHSN during the EHR reporting 

period; (2) Does not have an LIS or 

ADT system during the EHR reporting 

period; or (3) Does not have a data 

source containing the minimal discrete 

data elements that are required for 

reportina ** 

NIA (measure is YIN) I None NIA (measure is YIN) I None 
BILLING CODE 4120–01–C 39. On page 69621, top of the page, 

lines 1 and 2, the table title ‘‘TABLE ECQMS FOR ELIGIBLE HOSPITALS 

IX.F.–05: PREVIOUSLY FINALIZED 


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Protect Patient Health Information Protect Patient Health Information 

The eligible hospital or CAH is 

in active engagement to submit 

data to a clinical data regist 

Security Risk Analysis 

Conduct or review a security 

risk analysis in accordance with 

the requirements under 45 CFR 

164.308(a)(l), including 

addressing the security 

(including encryption) of data 

created or maintained by 

CEHRT in accordance with 

requirements under 45 CFR 

164.312(a)(2)(iv) and 45 CFR 

164.306( d)(3), implement 

security updates as necessary, 

and correct identified security deficiencies as part of the 

provider's risk management process. Actions included in 

the security risk analysis 

measure may occur any time 

during the calendar year in 

which the EHR reporting 

eriod occurs. 

NIA (measure is YIN) 

Safety Assurance Factors for IN/A (measure is YIN) 

EHR Resilience (SAFER) 

Guides Conduct an annual selfassessment using all nine 

SAFER Guides at any point 

during the calendar year in 

which the EHR reporting 

eriod occurs. 

NIA (measure is YIN) None NIA (measure is YIN) None 

* In the FY 2024 IPPS/L TCH PPS final rule (88 FR 59269), we inadvertently omitted a footnote describing changes to the phrasing of 

and description of the numerator in Table IX.F.-03.to align with the technical update finalized in the FY 2023 IPPS/L TCH PPS final ru

* * Signifies a measure finalized in this FY 2025 IPPS/L TCH PPS final rule that will apply to the EHR reporting period in CY 2025 and 

*** The ePrior Authorization measure will be required beginning with the EHR reporting period in CY 2027 (89 FR 8760). 
80112 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

AND CAHS FOR THE CY 2024 THE 

REPORTING PERIOD’’ is corrected to 

read ‘‘TABLE IX.F.–05: PREVIOUSLY 

FINALIZED ECQMS FOR ELIGIBLE 

HOSPITALS AND CAHS FOR THE CY 

2024 REPORTING PERIOD’’. 

40. On page 69622, third column, last 

paragraph, line 19, the phrase ‘‘CY 206’’ 

is corrected to read ‘‘CY 2026’’. 

41. On page 69880, third column, 

second full paragraph, line 2, the 

phrase, ‘‘supporting our CMS’s 

proposal’’ is corrected to read 

‘‘supported CMS’s proposal’’. 

42. On page 69901, lower half of the 

page, second column, partial paragraph, 

line 16, the phrase ‘‘section . and 

IX.E.7.b.’’ is corrected to read ‘‘section 

IX.E.7.b.’’. 

43. On page 69902, top of the page, in 

the table title ‘‘TABLE XII.B–08: U.S. 

BUREAU OF LABOR AND 

STATISTICS’ MAY 2021 NATIONAL 

OCCUPATIONAL EMPLOYMENT AND 

WAGE ESTIMATES, line 1, the date 

‘‘MAY 2021’’ is corrected to read ‘‘MAY 

2022’’. 

C. Corrections of Errors in the 

Addendum 

44. On page 69948, the table titled 

‘‘Summary of FY 2025 Budget 

Neutrality Factors’’ is corrected to read: 

45. On page 69955, third column, first 

full paragraph, line 6 through 11, the 

phrase ‘‘(estimated capital outlier 

payments of $292,195,135 divided by 

(estimated capital outlier payments of 

$292,195,135 plus the estimated total 

capital Federal payment of 

$6,564,012,091))’’ is corrected to read: 

‘‘(estimated capital outlier payments of 

$292,277,686 divided by (estimated 

capital outlier payments of 

$292,277,686 plus the estimated total 

capital Federal payment of 

$6,564,098,157))’’. 

46. On page 69960, third column: 

a. First full paragraph: 

i. Line 4, the figure ‘‘0.24849’’ is 

corrected to ‘‘0.248486’’, 

ii. Line 6, the figure ‘‘0.252248’’ is 

corrected to ‘‘0.252261’’, and 

iii. Line 17, the figure ‘‘1.015123’’ is 

corrected to ‘‘1.015192’’. 

b. Second full paragraph: 

i. Line 5, the figure ‘‘0.017716’’ is 

corrected to ‘‘0.017718’’, 

ii. Line 7, the figure ‘‘0.017666’’ is 

corrected to ‘‘0.017669’’, and 

iii. Line 18, the figure ‘‘0.997178’’ is 

corrected to ‘‘0.997234’’. 

47. On page 69961, second column: 

a. First full paragraph: 

i. Line 22, the figure ‘‘$46,152’’ is 

corrected to ‘‘$46,147’’, 

ii. Line 24, the figure 

‘‘$4,349,520,041’’ is corrected to 

‘‘$4,350,072,899’’, 

iii. Line 25, the figure 

‘‘$80,269,760,637’’ is corrected to 

‘‘$80,279,536,469’’, 

iv. Line 40, the figure ‘‘$46,502’’ is 

corrected to ‘‘$46,498’’, and 

v. Line 51, the figure ‘‘$46,152’’ is 

corrected to ‘‘$46,147’’. 

b. the untitled table, the figure 

‘‘0.957682’’ is corrected to ‘‘0.957678. 

48. On page 69963, the table titled 

‘‘CHANGES FROM FY 2024 

STANDARDIZED AMOUNTS TO THE 

FY 2025 STANDARDIZED AMOUNTS’’ 

is corrected to read as follows: 


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0.997190 

0.999874 

0.999981 

Reclassificatio 0.962786 

*Rural 0.977500 

0.997156 

0.999179 

0.999811 

*The rural floor budget neutrality factor is applied to the national wage indexes while the rest of the budget 

neutrality adjustments are applied to the standardized amounts. 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80113 

49. On page 69966, third column, first 

full paragraph, line 6, the figure ‘‘1.33 

percent’’ is corrected to read ‘‘1.30 

percent’’. 

50. On page 69969, second column, 

second partial paragraph, line 17, the 

figure ‘‘0.9887’’ is corrected to read 

‘‘0.9884’’. 

51. On page 69970: 

a. First column, first full paragraph, 

line 8, the mathematical phrase, 

‘‘(0.9887) is 0.9856 (0.9969 × 0.9887)’’ is 

corrected to read ‘‘(0.9884) is 0.9854 

(0.9969 × 0.9884)’’. 

b. Second column, second full 

paragraph, line 2, the figure ‘‘0.9856’’ is 

corrected to read ‘‘0.9854’’. 

c. Third column: 

i. First partial paragraph, line 5, the 

figure ‘‘$510.51’’ is corrected to read 

‘‘$510.39’’. 

ii. Second bulleted paragraph, line 12, 

the figure ‘‘0.9856’’ is corrected to read 

‘‘0.9854’’. 

iii. Last paragraph: 

A. Line 13, the figure ‘‘1.44’’ is 

corrected to read ‘‘1.46’’. 

B. Line 25, the figure ‘‘1.33’’ is 

corrected to read ‘‘1.30’’. 

52. On page 69971: 

a. Top of the page, the table titled 

‘‘COMPARISON OF FACTORS AND 

ADJUSTMENTS: FY 2024 CAPITAL 

FEDERAL RATE AND THE FY 2025 

CAPITAL FEDERAL RATE’’ is corrected 

to read as follows: 


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CHANGES FROM FY 2024 STANDARDIZED AMOUNTS TO THE FY 2025 

STANDARDIZED AMOUNTS 

Hospital Submitted Hospital Did NOT Hospital Did NOT 

Hospital Submitted Quality Data and is Submit Quality Data Submit Quality Data 

Quality Data and is a NOT a Meaningful EHR and is a Meaningful and is NOT a 

Meaningful EHR User User EHR User Meaningful EHR User 

FY 2025 Base Rate after removing: If Wage Index is Greater If Wage Index is Greater If Wage Index is If Wage Index is Greater 

1. FY 2024 Geographic Than 1.0000: Than 1.0000: Greater Than 1.0000: Than 1.0000: 

Reclassification Budget Neutrality Labor (67.6%): $ Labor (67.6%): $4,782.01 Labor (67.6%): Labor (67.6%): $4,782.01 

(0.971295) 4,782.01 Nonlabor (32.4%): $4,782.01 Nonlabor (32.4%): 

2. FY 2024 Operating Outlier Nonlabor (32.4%): $ $2,291.97 Nonlabor (32.4%): $2,291.97 

Offset (0.949) 2,291.97 $2,291.97 

3. FY 2024 Rural Demonstration If Wage Index is less If Wage Index is less Than If Wage Index is less If Wage Index is less 

Budget Neutrality Factor Than or Equal to 1.0000: or Equal to 1.0000: Than or Equal to 1.0000: Than or Equal to 1.0000: 

(0.999463) Labor (62%): $4,385.87 Labor (62%): $4,385.87 Labor (62%): $4,385.87 Labor (62%): $4,385.87 

4. FY 2024 Lowest Quartile Budget Nonlabor (38%): Nonlabor (38%): Nonlabor (38%): Nonlabor (38%): 

Neutrality Factor (0.997402) $2,688.11 $2,688.11 $2,688.11 $2,688.11 

5. FY 2024 Cap Policy Wage Index 

Budget Neutrality Factor 

(0.999645) 

FY 2025 Update Factor 1.029 1.0035 1.0205 0.995 

FY 2025 MS-DRG Reclassification 0.997190 0.997190 0.997190 0.997190 

and Recalibration Budget Neutrality 

Factor Before Cap 

FY 2025 Cap Policy MS-DRG 0.999874 0.999874 0.999874 0.999874 

Weight Budget Neutrality Factor 

FY 2025 Wage Index Budget 0.999981 0.999981 0.999981 0.999981 

Neutralitv Factor 

FY 2025 Reclassification Budget 0.962786 0.962786 0.962786 0.962786 

Neutralitv Factor 

FY 2025 Lowest Quartile Budget 0.997156 0.997156 0.997156 0.997156 

Neutrality Factor 

FY 2025 Cap Policy Wage Index 0.999179 0.999179 0.999179 0.999179 

Budget Neutralitv Factor 

FY 2025 RCH Demonstration 0.999811 0.999811 0.999811 0.999811 

Budget Neutralitv Factor 

FY 2025 Operating Outlier Factor 

0.949 0.949 0.949 0.949 

National Standardized Amount 

for FY 2025 if Wage Index is 

Greater Than 1.0000; Labor/NonLabor Share Percentage Labor: $4,465.41 Labor: $4,354.75 Labor: $4,428.52 Labor: $4,317.86 

(67.6/32.4) Nonlabor: $2,140.23 Nonlabor: $2,087.19 Nonlabor: $2,122.55 Nonlabor: $2,069.51 

National Standardized Amount 

for FY 2025 if Wage Index is Less 

Than or Equal to 1.0000; 

Labor/Non-Labor Share Labor: $4,095.5 Labor: $3,994.00 Labor: $4,061.66 Labor: $3,960.17 

Percentage (62/38) Nonlabor: $2,510.14 Nonlabor: $2,447.94 Nonlabor: $2,489.41 Nonlabor: $2,427.20 
80114 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

b. Lower three-fourths of the page, 

first column, second paragraph, last 

line, the figure ‘‘$46,152’’ is corrected to 

read ‘‘$46,147’’. 

53. On page 69987, first column, first 

full paragraph, 

a. Line 13, the figure ‘‘$46,152’’ is 

corrected to read ‘‘$46,147’’. 

b. Last line, the figure ‘‘$46,152’’ is 

corrected to read ‘‘$46,147’’. 

54. On page 69990: 

a. The table titled ‘‘TABLE 1A— 

NATIONAL ADJUSTED OPERATING 

STANDARDIZED AMOUNTS, LABOR/ 

NONLABOR (67.6 PERCENT LABOR 

SHARE/32.4 PERCENT NONLABOR 

SHARE IF WAGE INDEX IS GREATER 

THAN 11)—FY 2025’’ is corrected to 

read as follows: 

b. The table titled ‘‘TABLE 1B.— 

NATIONAL ADJUSTED OPERATING 

STANDARDIZED AMOUNTS, LABOR/ 

NONLABOR (62 PERCENT LABOR 

SHARE/38 PERCENT NONLABOR 

SHARE IF WAGE INDEX IS LESS 

THAN OR EQUAL TO 1)—FY 2025’’ is 

corrected to read as follows: 

c. The table titled ‘‘TABLE 1C.— 

ADJUSTED OPERATING 

STANDARDIZED AMOUNTS FOR 

HOSPITALS IN PUERTO RICO, 

LABOR/NONLABOR (NATIONAL: 62 

PERCENT LABOR SHARE/38 PERCENT 

NONLABOR SHARE BECAUSE WAGE 

INDEX IS LESS THAN OR EQUAL TO 

1)—FY 2025’’ is corrected to read as 

follows: 


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COMPARISON OF FACTORS AND ADJUSTMENTS: FY 2024 CAPITAL FEDERAL 

RATE AND THE FY 2025 CAPITAL FEDERAL RATE 

FY2024 FY2025 Chan2e Percent Chan2e 

Update Factor1 1.0380 1.0310 1.0310 3.10 

GAF/DRG Adiustment Factor1 0.9885 0.9854 0.9854 -1.46 

Quartile/Cap Adjustment Factor2 0.9964 0.9958 0.9993 -0.07 

Outlier Adjustment Factor3 0.9598 0.9577 0.9978 -0.22 

Capital Federal Rate $503.83 $510.39 1.0130 1.304 

1 The update factor and the GAF/DRG budget neutrality adjustment factors are built permanently into the capital Federal rate. Thus, for 

example, the incremental change from FY 2024 to FY 2025 resulting from the application of the 0.9854 GAF/DRG budget neutrality adjustment 

factor for FY 2025 is a net change of 0.9854 ( or -1.46 percent). 2 The lowest quartile/cap budget neutrality adjustment factor is not built permanently into the capital Federal rate; that is, the factor is not 

applied cumulatively in determining the capital Federal rate. Thus, for example, the net change resulting from the application of the FY 2025 

lowest quartile/cap budget neutrality adjustment factor is 0.9958/0.9964 or 0.9993 ( or -0.07 percent). 3 The outlier reduction factor is not built permanently into the capital Federal rate; that is, the factor is not applied cumulatively in determining 

the capital Federal rate. Thus, for example, the net change resulting from the application of the FY 2025 outlier adjustment factor is 

0.9577/0.9598 or 0.9978 (or -0.22 percent). 4 Percent change may not sum due to rounding. 

TABLE lA.- NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, 

LABOR/NONLABOR (67.6 PERCENT LABOR SHARE/32.4 PERCENT NONLABOR 

SHARE IF WAGE INDEX 

IS GREATER THAN 1)--FY 2025 

Hospital Submitted Quality Hospital Did NOT Submit Hospital Did NOT Submit 

Hospital Submitted Quality Data and is NOT a Quality Data and is a Quality Data and is NOT a 

Data and is a Meaningful EHR Meaningful EHR User Meaningful EHR User Meaningful EHR User 

User (Update= 2.9 Percent) (Update= 0.35 Percent) (Update= 2.05 Percent) (Update= -0.5 Percent) 

Labor I Nonlabor Labor I Nonlabor Labor I Nonlabor Labor I Nonlabor 

$4,465.41 I $2,140.23 $4,354.75 I $2,087.19 $4,42s.s2 I $2,122.55 $4,317.86 I $2,069.51 

TABLE lB.- NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, 

LABOR/NONLABOR (62 PERCENT LABOR SHARE/38 PERCENT NONLABOR 

SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1)-FY 2025 

Hospital Submitted Quality Hospital Did NOT Submit Hospital Did NOT Submit 

Hospital Submitted Quality Data and is NOT a Quality Data and is a Quality Data and is NOT a 

Data and is a Meaningful EHR Meaningful EHR User Meaningful EHR User Meaningful EHR User 

User (Update= 2.9 Percent) (Update= 0.35 Percent) (Update= 2.05 Percent) (Update= -0.5 Percent) 

Labor I Nonlabor Labor I Nonlabor Labor I Nonlabor Labor I Nonlabor 

$4,o9s.so I $2,510.14 $3,994.oo I $2,447.94 $4,061.66 I $2,489.41 $3,960.11 I $2,421.20 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80115 

d. The table titled ‘‘TABLE 1D.— 

CAPITAL STANDARD FEDERAL 

PAYMENT RATE—FY 2025’’ is 

corrected to read as follows: 

TABLE 1D.— CAPITAL STANDARD FEDERAL PAYMENT RATE—FY 2025 

Rate 

National ................................................................................................................................................................................................ $510.39 

D. Correction of Errors in the 

Appendices 

55. On page 69994, third column, first 

full paragraph, line 1, the figure ‘‘3,082’’ 

is corrected to read ‘‘3,083’’. 

56. On page 69996, third column: 

a. First full paragraph, line 7, the 

figure ‘‘3,082’’ is corrected to read 

‘‘3,083’’, 

b. Second full paragraph, line 5, the 

figure ‘‘690’’ is corrected to read ‘‘691’’. 

c. Third full paragraph, line 11, the 

figure ‘‘1,368’’ is corrected to read 

‘‘1,369’’. 

57. On page 69997: 

a. First column, first paragraph, line 4, 

the figure ‘‘1,832’’ is corrected to read 

‘‘1,833’’. 

b. Second column, first paragraph, 

line 7, the figure ‘‘244’’ is corrected to 

read ‘‘245’’. 

4. On pages 69998 through 70000, the 

table titled ‘‘Table I.—Impact Analysis 

of Changes to the IPPS for Operating 

Costs for FY 2025’’ is corrected to read 

as follows: 

BILLING CODE 4120–01–P 


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TABLE lC.-ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR 

HOSPITALS IN PUERTO RICO, LABOR/NONLABOR (NATIONAL: 62 PERCENT 

LABOR SHARE/38 PERCENT NONLABOR SHARE BECAUSE WAGE INDEX IS 

LESS THAN OR EQUAL TO 1)-FY 2025 

Hospital is a Meaningful EHR User Hospital is NOT a Meaningful EHR 

and Wage Index Less Than or Equal User and Wage Index Less Than or 

Rates if Wage Index Greater Than 1 to 1 (Update= 2.9 Percent) Equal to 1 (Update= 0.35 Percent) 

Labor I Nonlabor Labor I Nonlabor Labor I Nonlabor 

National1 Not Applicable I Not Applicable $4,095.50 I $2,510.14 $3,994.00 I $2,447.94 1 For FY 2025, there are no CBSAs in Puerto Rico with a national wage index greater than 1. 

ER02OC24.013</GPH>lotter on DSK11XQN23PROD with RULES1

All Hosoitals 

Bv Geo!!raohic Location: 

Urban hospitals 

Rural hospitals 

Bed Size (Urban): 

0-99 beds 

100-199 beds 

200-299 beds 

300-499 beds 

500 or more beds 

Bed Size (Rural): 

0-49 beds 

50-99 beds 

100-149 beds 150-199 beds 

200 or more beds 

Urban by Re!!ion: 

New England 

Middle Atlantic 

East North Central 

West North Central 

South Atlantic 

East South Central 

West South Central 

Mountain Pacific 

Rural by Re!!ion: 

NewEugland 

Middle Atlantic 

East North Central 

West North Central 

South Atlantic 

East South Central 

West South Central 

Mountain Pacific 

Puerto Rico 

Puerto Rico HosPitals 

Bv Pavment Classification: 

Urban hosPitals 

Rural areas 

TABLE 1.-IMPACT ANALYSIS OF CHANGES TO THE IPPS 

FOR OPERATING COSTS FOR FY 2025 

FY2025 

Weights and FY2025 RnraIFioor 

DRGChanges Wage Data with 

with with Application 

Application of Application of National 

Hospital Recalibration ofWage FY2025 RnraIFioor 

Nnmber Rate Bndget Budget MGCRB Budget 

of Update Neutrality Neutrality Reclassifications Neutrality 

Hosoitals 1 m' (2)3 (3)4 (4)' (5)• 

3,083 2.9 0.0 00 0.0 00 

2,392 2.9 0.0 00 -0.2 0.1 

691 2.9 -0.2 0.6 2.4 -0.7 

645 2.9 -0.3 0.4 -2.0 1.3 

682 2.9 -0.1 0.0 -0.8 1.1 

421 2.9 0.0 -0.1 -0.2 0.6 

394 2.9 0.0 0.1 0.3 0.2 

248 2.8 0.1 -0.1 0.0 -0.8 

341 2.8 -0.3 0.4 1.7 -0.7 

183 2.9 -0.3 0.3 2.7 -0.7 

91 2.9 -0.2 0.5 2.4 -0.7 

44 2.9 -0.1 0.6 2.3 -0.7 

32 2.9 -0.2 1.2 2.7 -0.9 

106 2.9 0.0 -1.6 7.0 0.0 

280 2.9 0.0 -1.6 -0.1 -0.5 

367 2.9 0.1 0.4 -0.5 -0.2 

156 2.9 -0.1 0.1 -1.7 -0.9 

396 2.9 0.0 1.5 -0.7 -0.1 

142 2.9 0.0 2.3 -1.8 -0.9 

358 2.9 0.1 1.2 -1.9 -0.9 

179 2.9 -0.1 I.I 0.0 0.1 

356 2.8 0.1 -1.7 0.0 2.3 

21 2.9 -0.1 0.1 2.7 -0.9 

52 2.9 -0.2 2.0 6.1 -I.I 

110 2.9 -0.2 0.2 3.6 -0.7 

78 2.9 -0.4 0.0 0.3 -0.3 

112 2.9 -0.3 0.4 1.3 -0.7 132 2.8 -0.1 1.5 2.0 -0.9 

120 2.8 -0.2 0.5 2.5 -0.8 

42 2.7 -0.3 0.3 -0.2 -0.2 

24 2.9 -0.2 00 2.6 -0.5 

52 2.9 -0.3 -2.1 -3.4 -0.7 

1,714 2.9 0.0 0.0 -2.4 1.6 1,369 2.9 0.0 0.0 1.9 -1.2 

Applic

Impnt

the F

Wage 

a

Outm

Adju

(

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FY2025 

Weights and FY2025 RnralFloor Applic

DRG Changes Wage Data with Imput

with with Application the F

Application of Application ofNatioual Wage 

Hospital Recalibration ofWage FY2025 Rural Floor a

Number Rate Budget Budget MGCRB Budget Outm

of Update Neutrality Neutrality Reclassifications Neutrality Adju

Hospitals' (1)' (2)3 (3)4 (4)' (5)6 (

Teachin!! Status: 

Nonteaching 1,833 2.9 -0.1 0.1 -0.6 1.3 

Fewer than 100 residents 958 2.9 -0.1 0.2 0.0 0.0 

100 or more residents 292 2.8 0.2 -0.3 0.4 -0.9 

UrbanDSH: 

Non-DSH 331 2.9 -0.3 0.0 -2.3 0.6 

100 or more beds 1,015 2.9 0.0 0.0 -2.5 1.7 

Less than 100 beds 368 2.9 -0.1 0.1 -2.5 1.9 

RuraIDSH: 

Non-DSH 83 2.8 -0.1 0.2 3.5 -1.3 

SCH 243 2.8 -0.2 0.1 0.4 -0.1 

RRC 791 2.9 0.0 -0.1 2.0 -1.2 

100 or more beds 39 2.9 0.1 0.6 -0.9 -1.3 

Less than 100 beds 213 2.8 -0.1 0.7 3.7 -1.3 

Urban teachin!! and DSH: 

Both teachin!! and DSH 581 2.9 0.0 00 -2.5 1.1 

Teachin!! and no DSH 52 2.9 -0.2 -0.3 -2.2 0.0 

No teaching and DSH 802 2.9 0.0 0.0 -2.5 2.8 

No teaching and no DSH 279 2.9 -0.3 0.2 -2.3 1.0 

Snecial Hosnital Tvnes: 

RRC 155 2.9 0.0 1.2 1.8 0.3 

RRC with Section 401 Reclassification 579 2.9 0.1 -0.1 2.2 -1.3 

SCH 245 2.8 -0.4 0.1 0.4 -0.2 

SCH with Section 401 Reclassification 34 2.9 0.0 0.0 0.2 -0.1 

SCHandRRC 119 2.9 -0.3 0.2 1.0 -0.4 

SCH and RRC with Section 401 Reclassification 46 2.9 -0.4 0.2 0.1 -0.1 

Tvpe of Ownership: 

Voluntarv 1,907 2.9 0.0 -0.1 0.2 -0.1 

Proprietarv 755 2.9 -0.1 0.7 -0.4 1.2 

Government 420 2.8 0.1 -0.3 -0.7 -0.3 

Medicare Utilization as a Percent oflnpatient Davs: 

0-25 1,362 2.9 0.1 0.2 -0.5 -0.1 

25-50 1,616 2.9 -0.1 -0.1 0.4 0.1 

50-65 65 2.9 -0.4 -1.5 -1.6 3.0 

Over 65 16 2.5 -2.5 0.5 0.1 -0.3 

Medicaid Utilization as a Percent oflnpatient Davs: 

0-25 1,911 2.9 -0.1 0.2 0.1 -0.1 

25-50 1,044 2.9 0.1 -0.2 0.0 0.0 

50-65 99 2.8 0.2 -1.0 -1.4 2.2 

Over 65 29 2.5 0.3 -0.3 -1.9 2.7 

FY 2025 Reclassifications: 

All Reclassified Hospitals 1,061 2.9 0.0 00 2.2 -1.0 

Non-Reclassified Hospitals 2,022 2.9 0.0 0.0 -2.6 1.2 

Urban Hospitals Reclassified 902 2.9 0.0 -0.1 1.9 -1.0 

Urban Non-reclassified Hospitals 1,501 2.9 0.0 0.0 -3.2 1.6 
BILLING CODE 4120–01–C 58. On page 70000, second column, 

second full paragraph, line 26, the figure ‘‘0.999981’’. 

‘‘1.000114’’ is corrected to read 


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FY2025 

Weights and FY2025 Rural Floor Applic

DRG Changes Wage Data with Imput

with with Application the F

Application of Application of National Wage 

Hospital Recalibration ofWage FY2025 Rural Floor a

Number Rate Budget Budget MGCRB Budget Outm

of Update Neutrality Neutrality Reclassifications Neutrality Adju

Hospitals' fl)' (2)3 (3)4 (4)' (5)6 (

Rural Hospitals Reclassified Full Year 281 2.9 -0.2 0.7 2.7 -0.8 Rural Non-reclassified Hospitals Full Year 399 2.8 -0.2 0.4 1.8 -0.7 

All Section 401 Reclassified Hospitals: 729 2.9 0.1 -01 1.9 -1.2 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) 51 2.9 -0.1 0.7 6.7 -1.3 

1 Because data necessary to classify some hospitals by category were missing, the total number of hospitals in each category may not equal the national total. Discharge data are from 

from the latest available reporting periods. 

2 This column displays the payment impact of the hospital rate update, including the 2.9 percent update to the national standardized amount and the hospital-specific rate (the 3.4 perce

by 0.5 percentage point for the productivity adjustment). 

3 This column displays the payment impact of the changes to the Version 42 GROUPER, the changes to the relative weights and the recalibration of the MS-DRG weights based on FY 

IO-percent cap where the relative weight for a MS-DRG would decrease by more than ten percent in a given fiscal year. This column displays the application of the recalibration budg

0.999874. 

4 This column displays the payment impact of the update to wage index data using FY 2021 cost report data. This column displays the payment impact of the application of the wage 

neutrality factor is 0.999981. 

5 Shown here are the effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB). The effects demonstrate the FY 2025 payment impa

the reclassifications scheduled to be in effect for FY 2025. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflects the geographic bu

6 This column displays the effects of the rural floor. The Affordable Care Act requires the rural floor budget neutrality adjustment to be a 100 percent national level adjustment. The r

to the wage index 0.977500. 

7 This column shows the combined impact of(!) the imputed floor for all-urban states; (2) the policy that requires hospitals located in frontier States have a wage index no less than 1.

an increase in a hospital's wage index if a threshold percentage ofresidents of the county where the hospital is located commute to work at hospitals in counties with higher wage inde

policies. 

8 This column displays the impact of the expiration of the MOH status on January I, 2025, a non-budget neutral payment provision. 

9 This column shows the estimated change in payments from FY 2024 to FY 2025. 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80119 

59. On page 70001: 

a. Top of the page, the table titled, 

‘‘FY 2025 Percentage Change in Area 

Wage Index Values’’ is corrected to read 

as follows: 

b. Lower three-fourths of the page, 

second column: 

i. Second full paragraph, line 6, the 

figure ‘‘0.977499’’ is corrected to read 

‘‘0.977500’’. 

ii. Fourth full paragraph, line 5, the 

figure ‘‘0.977499’’ is corrected to read 

‘‘0.977500’’. 

60. On pages 70003 and 70004, the 

table titled ‘‘Table II.—Impact Analysis 

of Changes for FY 2025 Acute Care 

Hospital Operating Prospective Payment 

System (Payments Per Discharge)’’ is 

corrected to read as follows: 

BILLING CODE 4120–01–P 


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Number of 

FY 2025 Percentage Change in Area Wage Index Values Hospitals 

Urban Rural 

Increase 10 percent or more 71 0 

Increase greater than or equal to 5 percent and less than 10 percent 298 71 

Increase or decrease less than 5 percent 1,805 611 

Decrease greater than or equal to 5 percent and less than 10 percent 177 2 

Decrease 10 percent or more 6 0 

Unchanged 14 0 
80120 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 


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TABLE 11.--IMP ACT ANALYSIS OF CHANGES FOR FY 2025 ACUTE CARE 

HOSPITAL OPERATING PROSPECTIVE PAYMENT SYSTEM 

(PAYMENTS PER DISCHARGE) 

Estimated Estimated 

Average FY 2024 Average 

Number of Payment Per FY 2025 Payment FY2025 

Hospitals Discharge Per Discharge Changes 

(1) (2) (3) (4) 

All Hosnitals 3,083 16,290 16,744 

Bv Geo!!ranhic Location: 

Urban hospitals 2,392 16,685 17,153 

Rural hospitals 691 12,024 12,331 

Bed Size (Urban): 

0-99 beds 645 12,090 12,221 

100-199 beds 682 13,147 13,484 

200-299 beds 421 14,849 15,262 

300-499 beds 394 16,536 16,979 

500 or more beds 248 20,839 21,506 

Bed Size (Rural): 

0-49 beds 341 10,087 10,250 

50-99 beds 183 11,670 11,837 

100-149 beds 91 11,491 11,810 

150-199 beds 44 12,948 13,403 

200 or more beds 32 14,692 15,249 

Urban bv Re!!ion: 

NewEn!!land 106 18,193 18,949 

Middle Atlantic 280 19,817 20,033 

East North Central 367 15,604 16,327 

West North Central 156 15,718 16,139 

South Atlantic 396 14,272 14,896 

East South Central 142 13,553 14,185 

West South Central 358 14,328 14,852 

Mountain 179 16,502 16,897 

Pacific 356 21,702 21,721 

Rural by Re!!ion: 

NewEn!!land 21 16,899 17,278 

Middle Atlantic 52 13,444 14,037 

East North Central 110 11,680 11,930 

West North Central 78 12,316 12,557 

South Atlantic 112 11,130 11,306 

East South Central 132 10,397 10,768 

West South Central 120 9,970 10,283 

Mountain 42 14,353 14,707 

Pacific 24 16,967 17,222 

Puerto Rico 

Puerto Rico Hospitals 52 9,519 9,738 

By Payment Classification: 

Urban hospitals 1,714 14,861 15,218 

Rural areas 1,369 17,632 18,177 

Teachin!! Status: 

Nonteachin!! 1,833 12,463 12,755 

Fewer than 100 residents 958 14,737 15,158 

100 or more residents 292 23,992 24,718 

UrbanDSH: 

Non-DSH 331 12,800 13,131 

100 or more beds 1,015 15,461 15,829 

Less than 100 beds 368 10,944 11,204 

RuralDSH: 

Non-DSH 83 15,996 16,309 

SCH 243 13,192 13,572 

RRC 791 18,261 18,843 

100 or more beds 39 17,229 17,915 

2.8 

2.8 

2.6 

1.1 

2.6 

2.8 

2.7 

3.2 

1.6 

1.4 

2.8 

3.5 

3.8 

4.2 

1.1 

4.6 

2.7 

4.4 

4.7 

3.7 

2.4 

0.1 

2.2 

4.4 

2.1 

2.0 

1.6 

3.6 

3.1 

2.5 

1.5 

2.3 

2.4 

3.1 

2.3 

2.9 

3.0 

2.6 

2.4 

2.4 

2.0 

2.9 

3.2 

4.0 

Less than 100 beds 213 9,643 9,467 -1.8 

Urban teachin!! and DSH: 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80121 

61. On page 70006, third column, last 

paragraph: 

a. Line 9, the figure ‘‘$13,660.95’’ is 

corrected to read ‘‘$13,661.19’’. 

b. Line 12, the figure ‘‘$21,150.86’’ is 

corrected to read ‘‘$21,184.97’’. 

62. On pages 70007 and 70008, the 

table titled ‘‘Table III—Provider Deciles 

by Beneficiary Characteristics’’ is 

corrected to read as follows: 


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Estimated Estimated 

Average FY 2024 Average 

Number of PaymeutPer FY 2025 Payment FY2025 

Hospitals Discharge Per Discharge Changes 

(1) (2) (3) (4) 

Both teaching and DSH 581 16,912 17,316 2.4 

Teaching and no DSH 52 13,954 14,250 2.1 

No teaching and DSH 802 12,670 12,969 2.4 

No teaching and no DSH 279 12,193 12,541 2.9 

Special Hospital Types: 

RRC 155 12,709 13,095 3.0 

RRC with Section 401 Reclassification 579 18,953 19,572 3.3 

SCH 245 12,363 12,688 2.6 

SCH with Section 401 Reclassification 34 15,214 15,679 3.1 

SCHandRRC 119 13,855 14,244 2.8 

SCH and RRC with Section 401 Reclassification 46 17,305 17,766 2.7 

Type of Ownership: 

Voluntarv 1,907 16,311 16,758 2.7 

Proprietary 755 14,281 14,745 3.2 

Government 420 18,780 19,262 2.6 

Medicare Utilization as a Percent of Inpatient Days: 

0-25 1,362 18,026 18,555 2.9 

25-50 1,616 15,011 15,416 2.7 

50-65 65 14,650 14,818 1.1 

Over 65 16 9,827 9,829 0.0 

Medicaid Utilization as a Percent of Inpatient Days: 

0-25 1,911 14,606 15,021 2.8 

25-50 1,044 18,591 19,115 2.8 

50-65 99 22,639 22,886 1.1 

Over 65 29 19,007 19,155 0.8 

FY 2025 Reclassifications: 

All Reclassified Hospitals 1,061 17,497 18,032 3.1 

Non-Reclassified Hospitals 2,022 15,057 15,428 2.5 

Urban Hosoitals Reclassified 902 18,121 18,677 3.1 

Urban Non-reclassified Hospitals 1,501 14,960 15,321 2.4 

Rural Hospitals Reclassified Full Year 281 12,254 12,610 2.9 

Rural Non-reclassified Hospitals Full Year 399 11,692 11,936 2.1 

All Section 401 Reclassified Hospitals: 729 18,638 19,225 3.2 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) 51 11,119 11,330 1.9 

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TABLE III. PROVIDER DECILES BY BENEFICIARY CHARACTERISTIC

All Hospitals I I 16,290.29 16,744.2

Oto 10 0.0%-0.2% 12,874.75 13,234.4

% Of Discharges for Beneficiaries 2 to 5 >l0to 50 0.2%- 0.3% 15,353.20 15,850.9

Who Are American Indian or 

Alaska Native 6to 9 >50to 90 0.3%- 1.2% 17,962.96 18,376.7

10 >90 to 100 1.2% - 33.6% 15,978.53 16,462.0

Oto 10 0.0%- 0.1% 10,569.26 10,882.7

% Of Discharges for Beneficiaries I 2 to 5 >l0to 50 0.1%- 0.8% 13,300.10 13,776.3

Who Are Asian or Pacific Islander I 6to 9 >50to 90 0.8%- 5.1% 16,818.40 17,342.6

10 >90 to 100 5.1%- 92.0% 22,670.05 22,794.5

Oto 10 0.0%- 0.4% 13,889.75 14,152.8

% Of Discharges for Beneficiaries I 2 to 5 >lOto 50 0.4%-4.0% 14,827.75 15,215.7

Who Are Black I 6to 9 >50to 90 4.0%- 23.6% 17,120.89 17,613.6

10 >90 to 100 23.6% - 93.8% 19,094.89 19,705.6

Oto 10 0.3%- 1.0% 12,561.00 12,961.4

% Of Discharges for Beneficiaries I 2 to 5 >lOto 50 1.0%-2.7% 14,277.73 14,798.2

Who Are Hispanic I 6to 9 >50to 90 2.7%- 21.4% 17,847.60 18,284.6

10 >90 to 100 21.4% - 98.3% 19,215.13 19,420.0

Oto 10 0.0%- 1.5% 13,909.22 14,228.0

% Of Discharges for Beneficiaries I 2 to 5 >l0to 50 1.5%-2.1% 15,717.56 16,142.3

Who Are Multiracial I 6to 9 >50to 90 2.1%- 3.0% 17,022.38 17,497.1

10 >90 to 100 3.0%- 11.1% 18,040.94 18,715.9

Oto 10 0.1%- 47.1% 21,226.18 21,579.0

% Of Discharges for Beneficiaries I 2 to 5 >l0to 50 47.1%- 85.0% 17,879.04 18,347.2

Who Are White I 6to 9 >50to 90 85.0%- 95.1% 14,161.90 14,625.3

10 >90 to 100 95.1%- 98.5% 12,325.67 12,666.1

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Oto 10 0.0%- 10.4% 13,698.87 14,167.6

% Of Discharges for Beneficiaries 2 to 5 >l0to 50 10.4% - 24.6% 14,859.85 15,307.5

Who Are Dual(All) Enrolled 6to 9 >50to 90 24.6% - 50.4% 17,958.89 18,469.5

During The Month Of Discharge 

10 >90 to 100 50.4% - 100.0% 21,271.95 21,401.9

Oto 10 0.0%- 12.2% 13,656.82 14,117.2

% Of Discharges for Beneficiaries 2 to 5 >l0to 50 12.2%- 27.1% 15,001.13 15,458.6

Who Are LIS Enrolled During The 

Month 6to 9 >50to 90 27.1%- 52.7% 17,870.54 18,366.6

Of Discharge 

10 >90 to 100 52.7% - 100.0% 21,194.10 21,337.9

% Of Discharges for Beneficiaries . Oto 10 0.0%- 12.3% 13,661.19 14,118.7

Who Are Dual(All) or LIS 2 to 5 >l0to 50 12.3% - 27.2% 14,995.26 15,453.4

Enrolled During The Month Of 6to 9 >50to 90 27.2% - 52.8% 17,882.77 18,377.7

Discharge 10 >90 to 100 52.8% - 100.0% 21,184.97 21,330.8

Oto 10 0% 12,573.38 12,922.0

% Of Discharges for Beneficiaries 2 to 5 >lOto 50 0.0%- 1.6% 15,128.47 15,573.3

With a Z code reported related to 6to 9 >50to 90 1.6%- 6.2% 17,126.11 17,597.7

SDOH ** 

10 >90 to 100 6.2% - 100.0% 17,909.79 18,325.4

Oto 10 0.0%- 35.6% 18,619.72 19,004.1

% Of Discharges for Beneficiaries 2 to 5 >lOto 50 35.6% - 46.8% 17,018.72 17,434.7

With a Behavioral Health 15,860.5

Diagnosis 6to 9 >50to 90 46.8% - 57.6% 15,357.00 

10 >90 to 100 57.6% - 100.0% 14,613.77 15,096.5

Oto 10 0.0%-0.8% 17,284.97 17,491.2

% Of Discharges for Beneficiaries I 2 to 5 >lOto 50 0.8%- 13.9% 16,781.33 17,262.2

who come from rural areas I 6to 9 >50to 90 13.9% - 93.3% 15,794.73 16,307.3

10 >90 to 100 93.3% - 100.0% 12,086.40 12,364.0

Oto 10 0% 10,894.52 11,208.6

% Of Discharges for Beneficiaries I 2 to 5 >lOto 50 0.0%-3.9% 13,554.49 13,919.1

With ESRD coverage** I 6to 9 >50to 90 3.9%-9.2% 16,842.90 17,328.4

10 >90 to 100 9.2%- 28.0% 21,531.91 22,073.1
63. On page 70011, top of the page, 

first column, partial paragraph, lines 2 technologies for which we are providing 

and 3, the phrase ‘‘estimates for the 6 5 new’’ is corrected to read ‘‘estimates 


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% Of Discharges for Beneficiaries 

with Disability 

% Of Discharges for Beneficiaries 

who live in an area with ADI >= 85 

2 to 5 

6 to 9 

10 

2 to 5 

6 to 9 

10 

0 to 10 

>10 to 50 >50to 90 

>90 to 100 

0 to 10 

>10 to 50 >50to 90 

>90 to 100 

0.0%-16.0% 14,293.82 14,661.02 

16.0%- 25.8% 15,816.63 16,239.43 

25.8% - 38.0% 17,228.91 17,728.75 

38.0% - 100.0% 18,115.89 18,722.72 

0.0%-0.4% 19,438.31 19,670.63 

0.4%- 10.3% 16,763.92 17,151.60 

10.3%- 46.1% 15,118.25 15,722.27 

46.1% - 100.0% 11,538.30 11,987.06 

* Decile group 1 contains the 10% of hospitals with the lowest rate of discharges for that characteristic; decile group 2 to 5 contains the hospitals with less than or 

for that characteristic, excluding those in decile group 1; decile group 6 to 9 contains the hospitals with greater than the median rate of discharges for that characte

decile group 10 contains the 10% of hospitals with the highest rate of discharges for that characteristic. 

** Greater than IO percent of providers did not report discharges associated with this characteristic. Therefore, we have randomly allocated those providers to deci
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80125 

for the 5 technologies for which we are 

providing 4 new’’. 

64. On page 70012: 

a. Second column, second paragraph, 

line 1, the number ‘‘2399’’ is corrected 

to ‘‘2400’’, and 

b. Third column, first paragraph, line 

6, the number ‘‘23’’ is corrected to ‘‘22’’. 

65. On pages 70013 and 70014, the 

table titled ‘‘Modeled Uncompensated 

Care Payments* and Supplemental 

Payments for Estimated FY 2025 DSHs 

by Hospital Type’’ is corrected to read 

as follows: 


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MODELED UNCOMPENSATED CARE PAYMENTS* AND SUPPLEMENTAL PAYMENTS FOR 

ESTIMATED FY 2025 DSHS BY HOSPITAL TYPE 

FY 2024 Final Rule FY 2025 Final Rule 

Estimated Estimated Dollar 

Uncompensated Uncompensated Care Difference: 

Care Payments and Payments and FY2024-

Number of Supplemental Supplemental FY2025 

Estimated Payments Payments** ($ in Percent 

DSHs ($ in millions) ($ in millions) millions) Change*** 

(1) (2) (3) (4) (5) 

Total 2,400 6,021 5,786 -236 -3.91% 

By Geographic Location 

Urban Hospitals 1,926 5,687 5,453 -233 -4.10 

Other Urban Areas 1,002 2,573 2,430 -143 -5.54 

Large Urban Areas 924 3,114 3,023 -91 -2.91 

Rural Hospitals 474 335 332 -2 -0.68 

Bed Size (Urban) 

0 to 99 Beds 377 230 237 8 3.40 

100 to 249 Beds 788 1,287 1,225 -62 -4.83 

250+ Beds 761 4,170 3,991 -179 -4.29 

Bed Size <Rural) 

0 to 99 Beds 362 183 179 -4 -2.06 

100 to 249 Beds 102 121 122 1 1.11 

250+ Beds 10 31 31 0 0.56 

Urban by Region 

New England 87 153 145 -8 -5.41 

Middle Atlantic 223 653 618 -35 -5.36 

South Atlantic 309 640 576 -64 -9.97 

East North Central 103 305 289 -16 -5.29 

East South Central 323 1,477 1,403 -74 -5.01 

West North Central 130 365 348 -17 -4.55 

West South Central 251 1,238 1,248 10 0.81 

Mountain 140 255 245 -10 -3.81 

Pacific 316 525 508 -17 -3.16 

Puerto Rico 44 75 72 -3 -4.20 

Rural by Region 

New England 9 10 9 -1 -9.03 

Middle Atlantic 32 19 17 -1 -7.01 

South Atlantic 70 41 42 1 2.50 

East North Central 30 20 21 1 5.07 

East South Central 87 94 96 1 1.37 

West North Central 111 66 63 -4 -5.47 

West South Central 107 70 70 0 -0.16 

Mountain 21 9 9 0 -0.67 
80126 Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 

BILLING CODE 4120–01–C 

66. On page 70014, first column, first 

paragraph, line 1 the language 

(beginning with the phrase ‘‘The 

changes in projected FY 2025 UCP and 

supplemental payments compared to 

the’’ and ending with the sentence 

‘‘Meanwhile, hospitals with less than 25 

percent Medicaid utilization and those 

with Medicaid utilization between 25– 

50 percent are projected to receive larger 

than average decreases of 4.44 percent 

and 4.31 percent, respectively.’’) is 

corrected to read as follows: ‘‘The 

changes in projected FY 2025 UCP and 

supplemental payments compared to 

the total of UCP and supplemental 

payments in FY 2024 are driven by 

changes in Factor 1 and Factor 2. The 

Factor 1 has increased from the FY 2024 

final rule’s Factor 1 of $10.015 billion to 

this final rule’s Factor 1 of $10.457 

billion. The Factor 2 has decreased from 

FY 2024 final rule’s Factor 2 of 59.29 

percent to this final rule’s Factor 2 of 

54.29 percent. In addition, we note that 

there is a slight increase in the number 


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MODELED UNCOMPENSATED CARE PAYMENTS* AND SUPPLEMENTAL PAYMENTS FOR 

ESTIMATED FY 2025 DSHS BY HOSPITAL TYPE 

FY 2024 Final Rule FY 2025 Final Rule 

Estimated Estimated Dollar 

Uncompensated Uncompensated Care Difference: 

Care Payments and Payments and FY2024-

Number of Supplemental Supplemental FY2025 

Estimated Payments Payments** ($ in Percent 

DSHs ($ in millions) ($ in millions) millions) Change*** 

(1) (2) (3) (4) 

Pacific 7 5 6 0 

By Payment Classification 

Urban Hospitals 1,345 3,165 3,046 -118 

Large Urban Areas 702 1,878 1,833 -45 

Other Urban Areas 643 1,287 1,214 -74 

Rural Hospitals 1,055 2,857 2,739 -117 

Teachin2 Status 

N onteaching 1,306 1,526 1,477 -49 

Fewer than 100 residents 812 2,133 2,028 -104 

100 or more residents 282 2,363 2,280 -83 

Type of Ownership 

Voluntarv 1,508 3,483 3,323 -160 

Proprietary 524 855 824 -31 

Government 367 1,683 1,638 -45 

Medicare Utilization 

Percent  

0 to 25 1,219 4,273 4,134 -139 

25 to 50 1,148 1,736 1,640 -96 

50 to 65 26 11 10 -1 

Greater than 65 7 1 1 0 

Medicaid Utilization 

Percent** ** 

0 to 25 1,315 2,349 2,246 -103 

25 to 50 950 2,937 2,810 -128 

50 to 65 107 610 598 -12 

Greater than 65 28 125 132 7 

Source: Dobson I DaVanzo analysis of 2019, 2020, and 2021 Hospital Cost Reports. 

*Dollar UCP calculated by [0.75 * estimated section 1886(d)(5)(F) payments* Factor 2 * Factor 3]. When summed across all 

hospitals projected to receive DSH payments, UCP and supplemental payments are estimated to be $6,021 million in FY 2024, 

and UCP and supplemental payments are estimated to be $5,786 million in FY 2025. 

** For IRS/Tribal hospitals and Puerto Rico hospitals, this impact table reflects the supplemental payments. 

*** Percentage change is determined as the difference between Medicare UCP and supplemental payments modeled for this FY 

2025 IPPS/L TCH PPS final rule ( column 3) and Medicare UCP and supplemental payments modeled for the FY 2024 

IPPS/L TCH PPS final rule correcting document ( column 2) divided by Medicare UCP and supplemental payments modeled for 

the FY 2024 IPPS/LTCH PPS final rule correcting document (column 2) times 100 percent. 

****Hospitals with missing or unknown Medicare utilization or Medicaid utilization are not shown in the table. 

(5) 

7.50 

-3.74 

-2.39 

-5.72 

-4.10 

-3.18 

-4.90 

-3.49 

-4.59 

-3.62 

-2.65 

-3.25 

-5.51 

-8.31 

-7.09 

-4.40 

-4.34 

-1.96 

5.76 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80127 

of projected DSH-eligible hospitals to 

2,400 at the time of the development for 

this final rule compared to the 2,384 

DSHs in the FY 2024 IPPS/LTCH PPS 

final rule (88 FR 58640). Based on the 

changes, the impact analysis found that, 

across all projected DSH-eligible 

hospitals, FY 2025 UCP and 

supplemental payments are estimated at 

approximately $5.786 billion, or a 

decrease of approximately 3.91 percent 

from FY 2024 UCP and supplemental 

payments (approximately $6.021 

billion). While the changes result in a 

net decrease in the total amount 

available to be distributed in UCP and 

supplemental payments, the projected 

payment amounts vary by hospital type. 

This redistribution of payments is 

caused by changes in Factor 3 and the 

amount of the supplemental payment 

for DSH-eligible IHS/Tribal hospitals 

and Puerto Rico hospitals. As seen in 

the previous table, a percent change of 

less than negative 3.91 percent indicates 

that hospitals within the specified 

category are projected to experience a 

larger decrease in payments, on average, 

compared to the universe of projected 

FY 2025 DSH-eligible hospitals. 

Conversely, a percentage change greater 

than negative 3.91 percent indicates that 

a hospital type is projected to have a 

smaller decrease compared to the 

overall average. The variation in the 

distribution of overall payments by 

hospital characteristic is largely 

dependent on a given hospital’s 

uncompensated care costs as reported 

on the Worksheet S–10 and used in the 

Factor 3 computation and whether the 

hospital is eligible to receive the 

supplemental payment. 

Rural hospitals, in general, are 

projected to experience a smaller 

decrease in UCP compared to the 

decrease their urban counterparts are 

projected to experience. Overall, rural 

hospitals are projected to receive a 0.68 

percent decrease in payments, while 

urban hospitals are projected to receive 

a 4.10 percent decrease in payments, 

which is slightly larger than the overall 

hospital average. 

By bed size, rural hospitals with 0 to 

99 beds are projected to receive a 

smaller than average decrease of 2.06 

percent in payments, while those with 

100 to 249 beds are projected to receive 

an increase of 1.11. Additionally, rural 

hospitals with 250+ beds are projected 

to receive a 0.56 percent increase in 

payments. Among urban hospitals, the 

smallest urban hospitals, those with 0 to 

99 beds, are projected to receive a 3.40 

percent increase in payments. In 

contrast, larger urban hospitals with 

100–249 beds and urban hospitals with 

250+ beds are projected to receive 

decreases in payments that are larger 

than the overall hospital average, at 4.83 

and 4.29 percent, respectively. 

By region, rural hospitals are 

projected to receive a varied range of 

payment changes. Rural hospitals in the 

New England, West North Central, and 

Middle Atlantic regions are projected to 

receive larger than average decreases in 

payments. Rural hospitals in all other 

regions are projected to receive either 

increases in payments or smaller than 

average decreases in payments. Urban 

hospitals in the West South Central, 

Mountain, and Pacific regions are 

projected to either receive either 

increases in payments or smaller than 

average decreases in payments, while 

urban hospitals in all other regions are 

projected to receive larger than average 

decreases in payments. 

By payment classification, hospitals 

in urban payment areas overall are 

expected to receive a 3.74 percent 

decrease in UCP and supplemental 

payments. Hospitals, in large urban 

payment areas are projected to receive a 

smaller than average decrease in 

payments of 2.39 percent. In contrast, 

hospitals in other urban payment areas 

and hospitals in rural payment areas are 

projected to receive a larger than 

average decrease in payments of 5.72 

and 4.10 percent, respectively. 

Nonteaching hospitals and teaching 

hospitals with 100+ residents are 

projected to receive a smaller than 

average payment decrease of 3.18 

percent and 3.49 percent, respectively. 

Teaching hospitals with fewer than 100 

residents are projected to receive larger 

than average payment decreases of 4.90 

percent. Voluntary hospitals are 

projected to receive larger than average 

decreases of 4.59 percent, while 

government-owned hospitals and 

proprietary hospitals are expected to 

receive a smaller than average payment 

decrease of 2.65 percent and 3.62 

percent, respectively. Hospitals with 

less than 25 percent Medicare 

utilization are projected to receive 

smaller than average decreases of 3.25 

percent. Hospitals with Medicare 

utilization between 25–50 percent, 50– 

65 percent, and greater than 65 percent 

are projected to receive larger than 

average decreases of 5.51 percent, 8.31 

percent, and 7.09 percent, respectively. 

Hospitals with 50–65 percent Medicaid 

utilization are projected to receive a 

smaller than average decreases in 

payments of 1.96 percent, while those 

with greater than 65 percent Medicaid 

utilization are projected to receive a 

5.76 percent increase in payments. 

Meanwhile, hospitals with less than 25 

percent Medicaid utilization and those 

with Medicaid utilization between 25– 

50 percent are projected to receive larger 

than average decreases of 4.40 percent 

and 4.34 percent, respectively.’’ 

67. On pages 70021 through 70022, in 

the table titled TABLE I.8.–01 IMPACT 

ANALYSIS OF BASE OPERATING DRG 

PAYMENT AMOUNTS RESULTING 

FROM THE FY 2025 HOSPITAL VBP 

PROGRAM, the table is corrected to 

read as follows: 

BILLING CODE 4120–01–P 


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TABLE 1.8.-01: Impact Analysis of Base Operating DRG Payment Amounts 

Resulting from the FY 2025 Hospital VBP Program 

Number of Average Net Percentage 

Hospitals Payment Adjustment 

[BY GEOGRAPHIC LOCATION: 

All Hospitals 2,471 0.135% 

Urban Area 1,950 0.059% 

Rural Area 521 0.422% 

Missing 

Urban Hospitals 1,950 0.059% 

0-99 beds 334 0.584% 

100-199 beds 603 0.157% 

200-299 beds 395 -0.136% 

300-499 beds 379 -0.177% 

500 or more beds 239 -0.227% 

Rural Hospitals 521 0.422% 

0-49 beds 194 0.742% 

50-99 beds 170 0.357% 

100-149 beds 89 0.264% 

150-199 beds 40 -0.068% 

200 or more beds 28 -0.207% 

[BY REGION: 

Urban By Region 1,950 0.059% 

New England 98 0.092% 

Middle Atlantic 245 -0.170% 

South Atlantic 354 0.093% 

East North Central 315 0.113% 

East South Central 109 -0.188% 

West North Central 127 0.267% 

West South Central 236 -0.138% 

Mountain 149 0.099% 

Pacific 317 0.261% 

Rural By Region 521 0.422% 

New England 21 0.559% 

Middle Atlantic 40 0.257% 

South Atlantic 85 0.376% 

East North Central 99 0.422% 

East South Central 88 0.168% 

West North Central 66 0.805% 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80129 

68. On page 70030: 

a. Second column, first full paragraph, 

line 4, the figure ‘‘0.9856’’ is corrected 

to read ‘‘0.9854’’. 

b. Second column, second full 

paragraph, line 6, the figure ‘‘3,082’’ is 

corrected to read ‘‘3,083’’. c. Third 

column, first full paragraph: 

i. Line 9, the figure ‘‘0.3’’ is corrected 

to read ‘‘0.4’’. 

ii. Line 14, the figure ‘‘2.2’’ is 

corrected to read ‘‘2.1’’. 

d. Third column, second full 

paragraph, line 12, the figure ‘‘2.8’’ is 

corrected to read ‘‘2.7’’. 

69. On pages 70031 through 70032, 

the table titled ‘‘Table III—Comparison 

of Total Payments per Case’’ is corrected 

to read as follows: 


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West South Central 71 0.237% 

Mountain 28 0.721% 

Pacific 23 0.821% 

BY MCR PERCENT: 

0-25 1,090 0.027% 

25-50 1,347 0.216% 

50-65 34 0.384% 

Over 65 

Missing 

BY DSH PERCENT: 

0-25 870 0.359% 

25-50 1,343 0.050% 

50-65 154 -0.178% 

Over 65 104 -0.177% 

Missing 

BY TEACHING STATUS: 

Non-Teaching 1,302 0.300% 

Teaching 1,169 -0.049% 
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TABLE III.-- COMPARISON OF TOTAL PAYMENTS PER CASE 

Average Average 

Number of FY2024 FY2025 

[FY 2024 PAYMENTS COMPARED TO FY 2025 PAYMENTS] Hosoitals Pavmeuts/Case Pavmeuts/Case Change 

All Hosoitals 3,083 1,155 1,187 2.8 

Bv Geograohic Location: 

Urban hosoitals 2,392 1,189 1,221 2.7 

Rural hosoitals 691 793 823 3.8 

Bed Size (Urban): 

0-99 beds 645 894 915 2.3 

100-199 beds 682 984 1,010 2.6 

200-299 beds 421 1,095 1,123 2.6 

300-499 beds 394 1,185 1,215 2.5 

500 or more beds 248 1,419 1,459 2.8 

Bed Size (Rural): 

0-49 beds 341 667 691 3.6 

50-99 beds 183 760 787 3.6 

100-149 beds 91 768 795 3.5 

150-199 beds 44 863 899 4.2 

200 or more beds 32 965 1,004 4.0 

Urban bv Region: 

New England 106 I 261 I 310 3.9 

Middle Atlantic 280 1,365 1,376 0.8 

East North Central 367 1,086 1,140 5.0 

West North Central 156 1 122 1 146 2.1 

South Atlantic 396 1,032 1,077 4.4 

East South Central 142 983 1,032 5.0 

West South Central 358 1,069 1,107 3.6 

Mountain 179 I 194 1220 2.2 

Pacific 356 1,564 1,562 -0.1 

Rural by Region: 

New England 21 1,048 1,085 3.5 

Middle Atlantic 52 894 939 5.0 

East North Central 110 768 814 6.0 

West North Central 78 785 804 2.4 

South Atlantic 112 736 754 2.4 

East South Central 132 724 760 5.0 

West South Central 120 701 730 4.1 

Mountain 42 867 882 1.7 

Pacific 24 1,070 1,066 -0.4 

Puerto Rico: 

Puerto Rico Hosoitals 52 623 636 2.1 

Bv Pavment Classification: 

Urban hospitals 1,714 1,102 1,127 2.3 

Rural areas 1,369 1,206 1,244 3.2 

Teaching Status: 

N onteaching I 833 945 970 2.6 

Fewer than 100 residents 958 1,079 1,110 2.9 

100 or more residents 292 1,565 1,606 2.6 

UrbanDSH: 

Non-DSH 331 985 1,010 2.5 

100 or more beds 1,015 1,140 1,166 2.3 

Less than 100 beds 368 817 836 2.3 

Rural DSH: 

Non-DSH 83 1,107 1,146 3.5 

SCH 243 823 847 2.9 

RRC 791 1,253 1,292 3.1 

I 00 or more beds 39 1,173 1,223 4.3 

Less than 100 beds 213 664 692 4.2 

Urban teaching and DSH: 

Both teaching and DSH 581 1 205 1 232 2.2 

Teaching and no DSH 52 1,031 1,053 2.1 

No teaching and DSH 802 996 1,019 2.3 

No teaching and no DSH 279 961 987 2.7 

Soecial Hosoital Tvoes: 

RRC 155 923 968 4.9 

RRC with Section 40 I Rural Reclassification 579 1,314 1,354 3.0 

SCH 245 766 792 3.4 

SCH with Section 40 I Rural Reclassification 34 947 972 2.7 

SCHandRRC 119 865 901 4.2 

SCH and RRC with Section 40 I Rural Reclassification 46 1,106 1,134 2.5 

Tvoe ofOwnershio: 
Federal Register / Vol. 89, No. 191 / Wednesday, October 2, 2024 / Rules and Regulations 80131 

E. Corrections of Errors in the 

Regulations Text 

§ 495.24 [Corrected] 

■ 70. On page 69914, in the first 

column, § 495.24(f)(1)(i)(C) is corrected 

to read: ‘‘(C) In 2025 earn a total score 

of at least 70 points’’. 

Elizabeth J. Gramling, 

Executive Secretary to the Department, 

Department of Health and Human Services. 

[FR Doc. 2024–22501 Filed 9–27–24; 4:15 pm] 

BILLING CODE 4120–01–C 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 412 

[CMS–1804–CN] 

RIN 0938–AV31 

Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for Federal Fiscal 

Year 2025 and Updates to the IRF 

Quality Reporting Program; Correction 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), Department 

of Health and Human Services (HHS). 

ACTION: Final rule; correction. 

SUMMARY: This document corrects 

technical and typographical errors in 

the final rule that appeared in the 

August 6, 2024 Federal Register entitled 

‘‘Medicare Program; Inpatient 

Rehabilitation Facility Prospective 

Payment System for Federal Fiscal Year 

2025 and Updates to the IRF Quality 

Reporting Program’’ (referred to 

hereafter as the ‘‘FY 2025 IRF final 

rule’’). The effective date of the FY 2025 

IRF final rule is October 1, 2024. 

DATES: This correction is effective 

October 1, 2024. 

FOR FURTHER INFORMATION CONTACT: Kia 

Burwell, (410) 786–7816. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2024–16911 of August 6, 

2024, the FY 2025 IRF final rule (89 FR 

64276), there were technical and 

typographical errors that are identified 

and corrected in this correcting 

document. These corrections are 

effective as if they had been included in 

the FY 2025 IRF final rule. Accordingly, 

the corrections are effective October 1, 

2024. 

II. Summary of Errors 

A. Summary of Errors in the Preamble 

On page 64304, we made a 

typographical error in the standard 

payment amount calculated following 

the application of the budget neutrality 

factor for the FY 2025 wage index due 

to the number being transposed in the 

original text. 

A technical error in the calculation of 

the final FY 2025 IRF PPS wage indexes 

require us to recalculate the impact 

analysis provided on pages 64335 and 

64336 in Table 17. Discussions of these 

errors are found in section IV. of this 

document. 

B. Summary of Errors and Corrections 

Posted on the CMS Website for the IRF 

Wage Index 

As discussed in the FY 2025 IRF PPS 

final rule (89 FR 64289 through 64291), 

in developing the wage index to be 

applied to IRFs under the IRF PPS, we 

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

wage data, exclusive of the occupational 

mix adjustment. For FY 2025, the 

updated, unadjusted, pre-reclassified, 

pre-rural floor IPPS wage data used 

under the IRF PPS are for cost reporting 

periods beginning on or after October 1, 

2020, and before October 1, 2021 (FY 

2021 cost report data), as discussed in 

the final rule entitled ‘‘Medicare and 

Medicaid Programs and the Children’s 

Health Insurance Program; Hospital 

Inpatient Prospective Payment Systems 

for Acute Care Hospitals and the LongTerm Care Hospital Prospective 

Payment System and Policy Changes 

and Fiscal Year 2025 Rates; Quality 

Programs Requirements; and Other 

Policy Changes’’ (89 FR 69896) 

(hereinafter referred to as the FY 2025 

IPPS final rule). In calculating the wage 

index under the FY 2025 IPPS final rule, 

we made an inadvertent error related to 

the calculation of the wage index. This 

error is identified, discussed, and 

corrected in the document entitled 

‘‘Medicare and Medicaid Programs and 

the Children’s Health Insurance 

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 

2025 Rates; Quality Programs 


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Average Average 

Number of FY2024 FY2025 

[FY 2024 PAYMENTS COMPARED TO FY 2025 PAYMENTS] Hospitals Payments/Case Payments/Case Cban2e 

Voluntary 1,907 1,158 1,189 2.7 

Proprietary 755 1,060 1,094 3.2 

Government 420 1,265 1,294 2.3 

Medicare Utilization as a Percent oflnpatient Davs: 

0-25 1,362 1,243 1,277 2.7 

25-50 1,616 1,091 1,122 2.8 

50-65 65 1,055 1,068 1.2 

Over65 16 719 725 0.8 

Medicaid Utilization as a Percent oflnpatient Davs: 

0-25 1,911 1,056 1,087 2.9 

25-50 1,044 1,289 1,323 2.6 

50-65 99 1,571 1,585 0.9 

Over65 29 1,348 1,353 0.4 

FY 2025 Reclassifications: 

All Reclassified Hospitals 1,061 1,210 1,248 3.1 

Non-Reclassified Hospitals 2,022 1,099 1,125 2.4 

Urban Hospitals Reclassified 902 1,256 1,294 3.0 

Urban Non-Reclassified Hospitals 1,501 1,108 1,133 2.3 

Rural Hospitals Reclassified Full Year 281 811 844 4.1 

Rural Non-Reclassified Hospitals Full Year 399 766 791 3.3 

All Section 401 Rural Reclassified Hospitals 729 1,281 1,320 3.0 

Other Reclassified Hospitals (Section 1886(d)(8)(B)) 51 808 842 4.2