With FFY 2027 approaching, it’s time to apply or request an extension for your hospital’s low-volume adjustment.
This is an additional payment for rural subsection (d) hospitals to help offset the cost of having lower patient volumes.
As outlined in Section 412.101 of the Inpatient PPS Medicare Final Rule, a qualifying hospital must:
- Have less than 3,800 total patient discharges in their most recent fiscal year
- Be located more than 15 road miles from the closest IPPS hospital
The Consolidated Appropriations Act, 2026 extended the above expanded criteria for qualifying hospitals through December 31, 2026.
Depending on the passage of the Consolidated Appropriations Act, 2027 this fall, criteria may revert to the original low-volume requirements of having fewer than 200 discharges and being greater than 25 road miles from the nearest IPPS hospital on January 1st, 2027. It is possible that the current expanded criteria will be extended into 2027.
We recommend all hospitals that qualify under the current expanded requirements apply for the FFY 2027 Low-Volume Payment Adjustment through their MAC.
Requests must be received no later than September 1st, 2026, to be considered.
Reach out to your local Blue & Co. advisor or contact one of our experts listed below if your organization needs more information about low-volume hospital payment adjustments.
Contact Blue & Co. about Low-Volume Hospital Payment Adjustments
Clint Brill, CPA, Senior Manager
Kyle Smith, CPA, 340B ACE, Director
Catherine Hegg, CPA, Senior Accountant
