Inpatient Medicaid Psychiatric Payment Rate Increases for New Units and Certain Hospitals

February 28, 2018

The Health Care Authority recently notified many hospitals of payment rate increases for inpatient psychiatric services authorized by the legislature in the 2017 legislative session budget.  WSHA advocated with the legislature for the additional appropriation and with HCA to implement the increases, which are effective retroactive to October 1, 2017. HCA will reprocess claims incurred since October 1 to reflect the new rates.

The rate increases apply to hospitals that provided more than 200 psychiatric inpatient days during the fiscal year. The legislative appropriation enables hospitals that have added new inpatient psychiatric services to be assigned a per diem rate based on a proportion of their facility-specific Medicaid cost rather than be paid at the statewide average.  The change also increases per diem rates for freestanding psychiatric hospitals and certain community hospitals where the Medicaid reimbursement was less than 78 percent of cost.  Chelene Whiteaker, ).


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