CMS Pub. 100-04, ch. 3, § 190.7.3

IPFs receive an additional payment for each ECT treatment furnished during the IPF stay.

The ECT base rate is based on the median hospital cost used to calculate the calendar year

2005 Outpatient Prospective Payment System (OPPS) amount for ECT and is updated

annually by the market basket and wage budget neutrality factor. The ECT base rate is

adjusted by the wage index and any applicable COLA factor.

For FY 2025, CMS used the pre-scaled and preadjusted CY 2024 OPPS geometric mean

cost of $675.93 as the basis for the IPF PPS ECT payment per treatment. CMS applied

the final FY 2025 IPF PPS payment rate update, refinement standardization factor, and

wage index budget neutrality factor to this amount to determine the ECT payment per

treatment for FY 2025.

In order to receive the payment, an IPF must report revenue code 0901 along with the

number of units of ECT on the claim. The units should reflect the number of ECT

treatments provided to the patient during the IPF stay. In addition, IPFs must include the

ICD-9-CM procedure code for ECT (94.27) in the procedure code field and use the date of

the last ECT treatment the patient received during their IPF stay.

Effective with the implementation of ICD-10 the following ICD-10-PCS codes apply:

ICD-10-PCS Code and Description

GZB0ZZZ - Electroconvulsive Therapy, Unilateral-Single Seizure

GZB2ZZZ - Electroconvulsive Therapy, Bilateral-Single Seizure

GZB4ZZZ – Other Electroconvulsive Therapy

It is important to note that since ECT treatment is a specialized procedure, not all

providers are equipped to provide the treatment. Therefore, many patients who need ECT

treatment during their IPF stay must be referred to other providers to receive the ECT

treatments, and then return to the IPF. In accordance with 42 CFR 412.404(d)(3), in these

cases where the IPF is not able to furnish necessary treatment directly, the IPF would

furnish ECT under arrangements with another provider. While a patient is an inpatient of

the IPF, the IPF is responsible for all services furnished, including those furnished under

arrangements by another provider. As a result, the IPF claim for these cases should reflect

the services furnished under arrangements by other providers.