IRS Announces Annual PCOR Fee Adjustment - IRS Notice 2025-61

The IRS has announced the annual increase in Patient-Centered Outcomes Research (PCOR) fees that must be paid by health insurers and self-insured health plan sponsors. PCOR fees were established by the Affordable Care Act (ACA) and are used to support clinical effectiveness research. Because the ACA provision included an expiration date, PCOR fees originally were collected only for plan years ending before October 1, 2019. However, legislation enacted at the end of 2019 reinstated the PCOR provision, continuing the fee requirements through plan years ending before October 1, 2029

The PCOR fee applicable dollar amount of $2.00 is adjusted annually based on the percentage increase in projected per capita national health expenditures. The adjusted applicable dollar amount for PCOR fees for plan and policy years ending on or after October 1, 2025, and before October 1, 2026, is $3.84. This is a $.37 increase from the amount in effect for plan and policy years ending on or after October 1, 2024, and before October 1, 2025. PCOR fees are calculated by multiplying the applicable dollar amount for the year by the plan’s or policy’s average number of covered lives.

PCOR fees are reported annually on the second quarter IRS Form 720 no later than July 31 of the calendar year immediately following the last day of the policy year or plan year to which the fee applies. Insurers, plan sponsors, and their advisors should confirm that this important date is noted on their compliance calendars.