Centers for Medicare and Medicaid Publish 2018 Supplemental Security Income Ratios

The Centers for Medicare and Medicaid (CMS) released the latest Supplemental Security Income (SSI) percentages for fiscal year (FY) 2018.

Below is important information about the publication of percentages.

Key Information

Applicable Health Care Entities

Updated SSI data was published for the following health care entities:

  • Inpatient Prospective Payment System (IPPS) hospitals
  • Inpatient rehabilitation facilities (IRFs)
  • Long-term care hospitals (LTCHs) that bill Medicare Administrative Contractors (MACs) for Medicare beneficiaries’ services


The FY 2018 SSI percentages are available electronically on the CMS website, with the following pages dedicated to each applicable health care entity:


On March 13, 2020, CMS issued a Change Request (CR) providing technical direction to MACs. The CR states that Medicare Part A “contractors shall update their IPPS, IRF, and LTCH provider specific files prospectively, within 30 days of the implementation date of this CR, using the latest year’s SSI Ratio that is posted to the CMS website as of the implementation date of this CR, except when explicitly directed otherwise by CMS.”

The guidance is effective on April 13, 2020.

Considerations for Hospitals

Hospitals should keep a few factors in mind based on their classification.

IPPS and IRF Hospitals

FY 2018 SSI ratios will generally be used for Medicare cost reports beginning on or after October 1, 2017 and prior to October 1, 2018 for settlement purposes.

For IPPS hospitals, this updated data will be used to determine their Medicare Disproportionate Share (DSH) adjustment. For those hospitals that don’t share the same fiscal year-end as the federal government—October 1 through September 30—a review is recommended to evaluate if the hospital would benefit from a recalculation.

Current CMS regulations allow a hospital to request its Medicare fraction or SSI ratio be recalculated based on the hospital’s cost-reporting period if it’s different from the federal fiscal year.

IRF hospitals will incorporate the updated percentages into their low-income patient adjustment.


Updated SSI data will be used for LTCH discharges paid under the short-stay outlier payment adjustment.

We’re Here to Help

If you have questions about potential implications of the SSI ratios for your hospital, contact your Moss Adams professional.

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