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2025 PCORI Fee

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The IRS has issued Notice 2024-83 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee to $3.47 per average covered life for plan years ending between October 1, 2024, and October 1, 2025. For plan years ending between October 1, 2023, and October 1, 2024, the fee is $3.22 per average covered life.

 

Applicability of PCORI Fee

The PCORI fee, established by the Affordable Care Act, applies to plan years ending on or after October 1, 2012, and funds comparative effectiveness research. Initially set to expire in 2019, it has been extended to apply through plan years ending before October 1, 2029.

 

Payment Deadline

PCORI fees must be reported and paid annually on IRS Form 720 by July 31 of the year after the plan year ends. For 2024 plan years, the fee is due by July 31, 2025. Self-insured employers should have completed their 2023 payments by July 31, 2024.

 

Calculating the PCORI Fee

PCORI fees are based on the average number of covered lives, including employees, spouses, and dependents, except for Health Reimbursement Arrangements or Flexible Spending Accounts. Final rules offer various methods for calculating this average. Download the bulletin for more details.

 

IRS Resources

PCORI Fee Overview Page

PCORI Fee: Questions and Answers

PCORI Fee Due Dates and Applicable Rates

Chart: Application of the PCORI Fee to Common Types of Health Coverage or Arrangements

 

National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Steve Smith

Steve Smith

Steve Smith is a powerhouse of energy, living by the mantra "work hard, play hard." As an expert in uniting teams for a greater purpose, Steve's innovative and creative strategies in employee health and wellness are game-changers. With over 25 years of expertise in health insurance, covering compliance, cost mitigation, utilization, analytics, wellness plans, and strategic planning, Steve is the go-to expert for driving down utilization trends and fostering a culture of well-being. His clients trust him to deliver exceptional results, making him an invaluable asset in the industry. As an Employee Benefits Consultant, Steve specializes in health care consulting for Minnesota public sector organizations including fully insured, self-insured, and stop-loss plans. Steve is a licensed insurance agent and holds the designations for Managed Healthcare Professional (The Health Insurance Association of America), Certified Patient Protection and Affordable Care Act Professional (National Association of Health Underwriters), and Group Benefits Disability Specialist (Hartford School of Insurance).