US · guidance
CMS Pub. 100-04, ch. 3, § 190.5.5
Variable Per Diem Adjustments
The variable per diem adjustments account for the ancillary and certain administrative
costs that occur disproportionately in the first days after admission to an IPF. The variable
per diem adjustments decline each day of the patient’s stay through day 10. After day 10,
the adjustments remain the same each day for the remainder of the stay.
Day-of-Stay Variable Per Diem Payment
Adjustment*
Day 1 - Facility Without a Qualifying
Emergency Department
1.28
Day 1 - Facility With a Qualifying Emergency
Department
1.54
Day 2 1.20
Day 3 1.15
Day 4 1.12
Day 5 1.08
Day 6 1.06
Day 7 1.03
Day 8 1.02
Day 9 1.01
Day 10 and After 1.00
*The adjustment for day 1 would be 1.54 or 1.28 depending on whether the IPF
has a qualifying emergency department or is a psychiatric unit in an acute care
hospital or CAH with a qualifying emergency department (see §190.6.4).
History
(Rev. 12830; Issued: 09-09-24; Effective: 10-01-24; Implementation: 10-07-24)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
4c4a3a13fbbad4d58ad94f2d7a1743e3cfb10ffdf8f9c19c84a828e56591662c
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