FY 2027 IPPS and LTCH instructions separate October 1 discharges from October 5 systems implementation
Sep 27, 2026 edition · GC-2026-0123 · Published 2026-09-27 · Version 2 · Final
CMS’s September 11 instructions align FY 2027 inpatient rates, Grouper/MCE 44.0, Pricers and provider files with October 1 discharges and October 5 implementation.
What happened
CMS issued R13930CP on September 11 under CR 14592 for FY 2027 Inpatient Prospective Payment System and Long-Term Care Hospital PPS changes. The instructions generally apply to hospital discharges from October 1, 2026 through September 30, 2027, unless otherwise specified, and give October 5 as the contractor implementation date. Updated IPPS and LTCH Pricers incorporate the year’s rates, factors and policies. Contractors must use the applicable final-rule tables, data and MAC implementation files, including a correcting-document version where CMS instructs, and install the appropriate Pricers to calculate payments for the affected discharges.
The update specifies MS-DRG Grouper and Medicare Code Editor version 44.0, selected by discharge date. CMS deletes 18 MS-DRGs and adds 14, leaving 768 for FY 2027. The accompanying instructions address the wage index, reclassifications and redesignations through provider-specific-file updates, with separate IPPS and LTCH requirements and applicable cost-of-living adjustments for Alaska and Hawaii. File selection, coding logic and provider attributes therefore need to reconcile with the correct payment system and discharge period; the October 5 systems implementation date does not replace the October 1 discharge boundary.
Scope and timing
- Authority status
- Final
- Applicability
- Directly applicable
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
- Affected functions
- Revenue Cycle, Finance, Coding, IT, Compliance
- Responsible owner
- Revenue Cycle
- Recorded date
- 2026-10-01
- Date type
- effective
Why it matters
A hospital can have current coding software yet misprice claims if the Pricer or provider-specific attributes are mismatched. Discharge-date testing helps distinguish these errors before the annual payment transition.
Recommended action
Have revenue cycle and finance verify the applicable FY 2027 tables, Pricers, provider-specific files and Grouper/MCE 44.0. Reconcile representative IPPS and LTCH test discharges around October 1, track October 5 systems implementation, and record vendor/file versions and unresolved differences without presuming files are already loaded.
Implementation playbook
- Internal preparation target: verify availability and versions of FY 2027 rate, coding and policy files; follow up if incomplete. Revenue Cycle · Due 2026-09-25
- Internal testing target: run and reconcile representative IPPS and LTCH discharge-date claims; do not infer completion. IT · Due 2026-09-28
- Internal readiness target: verify October 1 discharge applicability and track the distinct October 5 systems implementation. Finance · Due 2026-09-30
Sources
- MLN Connects Newsletter, September 17, 2026Official · Centers for Medicare and Medicaid Services · 2026-09-17 · Source review 2026-09-20
- R13930CP complete CMS transmittalOfficial · Centers for Medicare & Medicaid Services · 2026-09-11 · Source review 2026-10-15
Complete edition and supplemental material
This finding in the complete approved report →Regulatory horizons, CIA trends and implementation trackers remain in the full report.
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