IHACPA Determinations Released for 2025-26

The Independent Health and Aged Care Pricing Authority (IHACPA) has released two key determinations for 2025-26:

• National Efficient Price (NEP) which sets Australian Government payments for in-scope public hospital services that are funded on an activity basis. The NEP for 2025–⁠26 is $7,258 per national weighted activity unit.
• National Efficient Cost (NEC) which determines the Australian Government funding contribution for services that are block funded, such as for small rural hospitals. For NEC 2025–26, the fixed cost is $2.637 million and the variable cost is $7,617.

Key changes for 2025-26 include:

• Pricing community mental health care services using the Australian Mental Health Care Classification Version 1.1
• Measures to support the transition of community mental health care to ABF
• Implementation of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), the Australian Classification of Health Interventions and the Australian Coding Standards
• Pricing emergency department services using the Australian Emergency Care Classification Version 1.1

The determinations are based on an extensive program of research and analysis into healthcare needs and changes, summarised in the Pricing Framework for Australian Public Hospital Services 2025-26. The Administrator of the National Health Funding Pool will use the determinations to calculate the Australian Government funding contribution for Australian public hospital services in the 2025–26 financial year.