US · guidance
CMS Pub. 100-04, ch. 4, § 10.6.2.1
Hospitals to Which the Payment Reduction Applies
The reduction applies only to hospitals that are identified as “Subsection (d) hospitals.”
“Subsection (d) hospitals” have the same definition for hospitals paid under the OPPS as
for hospitals paid under the IPPS. Specifically, “Subsection (d) hospitals” are defined
under Section 1886(d)(1)(B) of the Act as hospitals that are located in the 50 states or the
District of Columbia other than those categories of hospitals or hospital units that are
specifically excluded from the IPPS, including psychiatric, rehabilitation, long-term care,
children’s and cancer hospitals or hospital units. In other words, the provision does not
apply to hospitals and hospital units excluded from the IPPS or to hospitals located in
Maryland, Puerto Rico or the U.S. territories. Hospitals that are not required to submit
quality data (i.e., those that are not Subsection (d) hospitals) will receive the full OPPS
update. Similarly, the reduced update will not apply to Subpart (d) hospitals that are not
paid under the OPPS (e.g., Indian Health Service hospitals).
History
(Rev. 1657, Issued: 12-31-08, Effective: 01-01-09, Implementation: 01-05-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
be282c6503eb74957b28ded45ed0a25776fbea24c7ec30a21dc607f95eb88f56
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