On April 10, 2026, CMS released its proposed rule describing federal fiscal year (FY) 2027 policies and rates for Medicare’s inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) prospective payment system (PPS). The proposed rule was published in the Federal Register on April 14, 2026. The public comment period will end on June 9.
The payment rates and policies described in the FY 2027 IPPS proposed rule affect Medicare’s operating and capital payments for short-term acute care hospital inpatient services and services provided in LTCHs paid under their respective PPS. Unless otherwise specified, policies will be effective October 1, 2026.
Beginning October 1, 2027, CMS is expanding the Comprehensive Joint Replacement (CJR-X) nationwide. CJR-X would be required for most hospitals, making it the first mandatory application of an episode-based payment model. In addition, CMS is eliminating the alternative pathway for a technology to be approved for new technology add-on payment where the technology only had to meet a cost test, not a test of newness and substantial clinical improvement. There is also a proposal that to be an approved medical residency training program or approved nursing and allied health education program to receive funding from CMS, these programs may not discriminate based on race, color, national origin, sex, age, disability, or religion.
CMS makes many data files available to support analysis of the proposed rule. These data files are generally available at: FY 2027 IPPS Proposed Rule Home Page | CMS. Numbered tables included in the IPPS/LTCH rule are only available on the CMS website at this hyperlink.
