# Bulletin No. 2025–47

> Briefs, arguments, decisions, and more.

URL: https://www.frixlaw.com/law-library/documents/agency%3Airs%3A15c482d5ef91b6b4

## Record

- **Collection:** Agency decision
- **Document type:** Agency decision

## Text

HIGHLIGHTS
OF THIS ISSUE




Bulletin No. 2025–47
November 17, 2025

These synopses are intended only as aids to the reader in
identifying the subject matter covered. They may not be
relied upon as authoritative interpretations.

EMPLOYEE PLANS, EXCISE TAX
Notice 2025-65, page 717.

This notice provides the indexing factors to be used by group
health plans and health insurance issuers to calculate the qualifying payment amount (QPA) for items or services provided on

Finding Lists begin on page ii.

or after January 1, 2026, and before January 1, 2027. The QPA
is the basis for determining individual cost sharing for items and
services covered by the balance-billing protections in the No
Surprises Act (NSA), under certain circumstances. The QPA for
a given calendar year is based on information regarding median
rates for certain items and services from prior years and is
indexed based on changes in the consumer price index.

The IRS Mission
Provide America’s taxpayers top-quality service by helping
them understand and meet their tax responsibilities and
enforce the law with integrity and fairness to all.

Introduction
The Internal Revenue Bulletin is the authoritative instrument
of the Commissioner of Internal Revenue for announcing official rulings and procedures of the Internal Revenue Service
and for publishing Treasury Decisions, Executive Orders, Tax
Conventions, legislation, court decisions, and other items of
general interest. It is published weekly.
It is the policy of the Service to publish in the Bulletin all substantive rulings necessary to promote a uniform application
of the tax laws, including all rulings that supersede, revoke,
modify, or amend any of those previously published in the
Bulletin. All published rulings apply retroactively unless otherwise indicated. Procedures relating solely to matters of internal management are not published; however, statements of
internal practices and procedures that affect the rights and
duties of taxpayers are published.
Revenue rulings represent the conclusions of the Service
on the application of the law to the pivotal facts stated in
the revenue ruling. In those based on positions taken in rulings to taxpayers or technical advice to Service field offices,
identifying details and information of a confidential nature are
deleted to prevent unwarranted invasions of privacy and to
comply with statutory requirements.
Rulings and procedures reported in the Bulletin do not have the
force and effect of Treasury Department Regulations, but they
may be used as precedents. Unpublished rulings will not be
relied on, used, or cited as precedents by Service personnel in
the disposition of other cases. In applying published rulings and
procedures, the effect of subsequent legislation, regulations,
court decisions, rulings, and procedures must be considered,
and Service personnel and others concerned are cautioned

against reaching the same conclusions in other cases unless
the facts and circumstances are substantially the same.
The Bulletin is divided into four parts as follows:
Part I.—1986 Code.
This part includes rulings and decisions based on provisions
of the Internal Revenue Code of 1986.
Part II.—Treaties and Tax Legislation.
This part is divided into two subparts as follows: Subpart A,
Tax Conventions and Other Related Items, and Subpart B,
Legislation and Related Committee Reports.
Part III.—Administrative, Procedural, and Miscellaneous.
To the extent practicable, pertinent cross references to these
subjects are contained in the other Parts and Subparts. Also
included in this part are Bank Secrecy Act Administrative
Rulings. Bank Secrecy Act Administrative Rulings are issued
by the Department of the Treasury’s Office of the Assistant
Secretary (Enforcement).
Part IV.—Items of General Interest.
This part includes notices of proposed rulemakings, disbarment and suspension lists, and announcements.
The last Bulletin for each month includes a cumulative index
for the matters published during the preceding months. These
monthly indexes are cumulated on a semiannual basis, and are
published in the last Bulletin of each semiannual period.

The contents of this publication are not copyrighted and may be reprinted freely. A citation of the Internal Revenue Bulletin as the source would be appropriate.

November 17, 2025 

Bulletin No. 2025–47

Part III
26 CFR 54.9816-6T:
Calculating the qualifying
payment amount in 2026
Notice 2025-65
SECTION 1. PURPOSE AND SCOPE
Pursuant to Treas. Reg. § 54.98166T(c), 29 CFR 2590.716-6(c), and 45 CFR
149.140(c), this notice provides the percentage increase for calculating the qualifying payment amounts (QPAs) for items
and services furnished during 2026 for
purposes of sections 9816 and 9817 of the
Internal Revenue Code (Code), sections
716 and 717 of the Employee Retirement
Income Security Act of 1974 (ERISA), and
sections 2799A-1 and 2799A-2 of the Public Health Service Act (PHS Act). These
provisions, added by the No Surprises Act,1
provide protections against surprise medical bills in certain circumstances. Similar
guidance for items and services furnished
during 2022, 2023, 2024, and 2025 was
published in Revenue Procedure 2022-11,
Notice 2022-11, Notice 2023-4, Notice
2024-1, and Notice 2025-12.2
SECTION 2. BACKGROUND
The QPA serves as the basis for calculating patient cost sharing for items or
services subject to the surprise billing provisions of the No Surprises Act in certain
circumstances. The QPA is also one of the
factors considered by a certified indepen-

BASE YEAR OF
QPA ORIGINATION
2019
2021
2022
2023
2024
2025
1
2

dent dispute resolution (IDR) entity to
determine which of two offers submitted
by parties to a payment dispute in the Federal IDR process best represents the value
of a qualified IDR item or service as the
out-of-network rate.
The QPA is generally the median of the
contracted rates recognized by the plan or
issuer on January 31, 2019, for the same or
similar item or service that is provided by
a provider in the same or similar specialty
or a facility of the same or similar facility type and provided in the geographic
region in which the item or service is furnished, increased for inflation. Pursuant
to Treas. Reg. § 54.9816-6T(c), 29 CFR
2590.716-6(c), and 45 CFR 149.140(c),
plans and issuers were first required to
calculate the QPA for items and services
furnished during 2022. Thus, 2019 generally is the base year for items and services
furnished in 2022, increased for all subsequent years. The median contracted rate is
determined with respect to all plans of the
plan sponsor or all coverage offered by the
issuer that are offered in the same insurance market. In general, for years after
2022, the plan or issuer must calculate the
QPA by increasing the QPA determined
for an item or service furnished in the
immediately preceding year by the percentage increase, as published in annual
guidance. QPAs determined based on later
years (for example, QPAs for group health
plans or health insurance issuers not offering coverage in 2019 or items or services
not covered in 2019) are adjusted based on
the year for which the QPA is first determined.

CUMULATIVE PERCENTAGE
INCREASE FOR QPA FROM
BASE YEAR TO 2025
1.2474117141
1.2065574831
1.1714409585
1.0878321254
1.0317904930
1.0000000000

SECTION 3. GUIDANCE
The percentage increase in the CPI-U
over a preceding year is calculated by dividing the average CPI-U for the preceding year
by the average CPI-U for the year immediately prior to the preceding year. For this
purpose, the average CPI-U for a year is the
average of the monthly CPI-Us published by
the Bureau of Labor Statistics of the Department of Labor for the 12-month period ending on August 31 of each year, rounded to
10 decimal places. The percentage increase
in the CPI-U for items and services provided
in 2026 over the preceding year is the average CPI-U for 2025 over the average CPI-U
for 2024. Pursuant to this calculation, the
percentage increase from 2025 to 2026 is
1.0265311701. Further, pursuant to prior
notices, plans and issuers may round any
resulting QPAs to the nearest dollar.
To calculate the adjusted QPA, the prior
year’s adjusted QPA is multiplied by the
percentage increase for the most recent year.
To simplify this calculation, this notice provides cumulative percentage increases. To
calculate the adjusted QPA for items and services furnished in 2026 using the cumulative
percentage increase, the “base year” QPA
is multiplied by the cumulative percentage
increase for the year the base QPA originated.
A plan or issuer may choose whether to use
the cumulative percentage increase or the
percentage increase, but the selected method
must be applied consistently for all QPAs
calculated for items and services furnished
during 2026. A plan or issuer is not permitted
to use one method for certain QPAs and a different method for other QPAs.

PERCENTAGE
INCREASE FOR QPA
FROM 2025 TO 2026
1.0265311701
1.0265311701
1.0265311701
1.0265311701
1.0265311701
1.0265311701

CUMULATIVE PERCENTAGE
INCREASE FOR QPA FROM
BASE YEAR TO 2026
1.2805070065
1.2385688649
1.2025206578
1.1166935846
1.0591651021
1.0265311701

The No Surprises Act was enacted as Title I of Division BB of the Consolidated Appropriations Act, 2021, Pub. L. 116-260, 134 Stat. 1182 (2020).
Revenue Procedure 2022-11, 2022-3 IRB 449; Notice 2022-11, 2022-14 IRB 939, Notice 2023-4, 2023-2 IRB 321, Notice 2024-1, 2023-2 IRB 314, and Notice 2025-12, 2025-8 IRB 813.

Bulletin No. 2025–47

717

November 17, 2025

See Notice 2024-1 and Notice 2025-12
regarding the application of these percentage increases.
SECTION 4. EFFECTIVE DATE
The effective date of this notice is January 1, 2026.

November 17, 2025

SECTION 5. DRAFTING
INFORMATION

contact 202-317-5500 (not a toll-free
number).

The principal author of this notice is
the Office of Associate Chief Counsel
(Employee Benefits, Exempt Organizations, and Employment Taxes). For further information regarding this notice,

718

Bulletin No. 2025–47

Definition of Terms
Revenue rulings and revenue procedures
(hereinafter referred to as “rulings”) that
have an effect on previous rulings use the
following defined terms to describe the
­effect:
Amplified describes a situation where
no change is being made in a prior published position, but the prior position is
being extended to apply to a variation of
the fact situation set forth therein. Thus,
if an earlier ruling held that a principle
applied to A, and the new ruling holds that
the same principle also applies to B, the
earlier ruling is amplified. (Compare with
modified, below).
Clarified is used in those instances
where the language in a prior ruling is
being made clear because the language
has caused, or may cause, some confusion. It is not used where a position in a
prior ruling is being changed.
Distinguished describes a situation
where a ruling mentions a previously published ruling and points out an essential
difference between them.
Modified is used where the substance
of a previously published position is being
changed. Thus, if a prior ruling held that a
principle applied to A but not to B, and the

new ruling holds that it applies to both A
and B, the prior ruling is modified because
it corrects a published position. (Compare
with amplified and clarified, above).
Obsoleted describes a previously published ruling that is not considered determinative with respect to future transactions.
This term is most commonly used in a ruling
that lists previously published rulings that
are obsoleted because of changes in laws or
regulations. A ruling may also be obsoleted
because the substance has been included in
regulations subsequently adopted.
Revoked describes situations where the
position in the previously published ruling
is not correct and the correct position is
being stated in a new ruling.
Superseded describes a situation where
the new ruling does nothing more than
restate the substance and situation of a
previously published ruling (or rulings).
Thus, the term is used to republish under
the 1986 Code and regulations the same
position published under the 1939 Code
and regulations. The term is also used
when it is desired to republish in a single
ruling a series of situations, names, etc.,
that were previously published over a
period of time in separate rulings. If the

new ruling does more than restate the substance of a prior ruling, a combination of
terms is used. For example, modified and
superseded describes a situation where the
substance of a previously published ruling
is being changed in part and is continued
without change in part and it is desired to
restate the valid portion of the previously
published ruling in a new ruling that is
self contained. In this case, the previously
published ruling is first modified and then,
as modified, is superseded.
Supplemented is used in situations in
which a list, such as a list of the names of
countries, is published in a ruling and that
list is expanded by adding further names
in subsequent rulings. After the original
ruling has been supplemented several
times, a new ruling may be published that
includes the list in the original ruling and
the additions, and supersedes all prior rulings in the series.
Suspended is used in rare situations
to show that the previous published rulings will not be applied pending some
future action such as the issuance of new
or amended regulations, the outcome of
cases in litigation, or the outcome of a
Service study.

Abbreviations
The following abbreviations in current
use and formerly used will appear in
material published in the Bulletin.

A—Individual.
Acq.—Acquiescence.
B—Individual.
BE—Beneficiary.
BK—Bank.
B.T.A.—Board of Tax Appeals.
C—Individual.
C.B.—Cumulative Bulletin.
CFR—Code of Federal Regulations.
CI—City.
COOP—Cooperative.
Ct.D.—Court Decision.
CY—County.
D—Decedent.
DC—Dummy Corporation.
DE—Donee.
Del. Order—Delegation Order.
DISC—Domestic International Sales Corporation.
DR—Donor.
E—Estate.
EE—Employee.
E.O.—Executive Order.
ER—Employer.

Bulletin No. 2025–47

ERISA—Employee Retirement Income Security Act.
EX—Executor.
F—Fiduciary.
FC—Foreign Country.
FICA—Federal Insurance Contributions Act.
FISC—Foreign International Sales Company.
FPH—Foreign Personal Holding Company.
F.R.—Federal Register.
FUTA—Federal Unemployment Tax Act.
FX—Foreign corporation.
G.C.M.—Chief Counsel’s Memorandum.
GE—Grantee.
GP—General Partner.
GR—Grantor.
IC—Insurance Company.
I.R.B.—Internal Revenue Bulletin.
LE—Lessee.
LP—Limited Partner.
LR—Lessor.
M—Minor.
Nonacq.—Nonacquiescence.
O—Organization.
P—Parent Corporation.
PHC—Personal Holding Company.
PO—Possession of the U.S.
PR—Partner.
PRS—Partnership.

i

PTE—Prohibited Transaction Exemption.
Pub. L.—Public Law.
REIT—Real Estate Investment Trust.
Rev. Proc.—Revenue Procedure.
Rev. Rul.—Revenue Ruling.
S—Subsidiary.
S.P.R.—Statement of Procedural Rules.
Stat.—Statutes at Large.
T—Target Corporation.
T.C.—Tax Court.
T.D.—Treasury Decision.
TFE—Transferee.
TFR—Transferor.
T.I.R.—Technical Information Release.
TP—Taxpayer.
TR—Trust.
TT—Trustee.
U.S.C.—United States Code.
X—Corporation.
Y—Corporation.
Z—Corporation.

November 17, 2025

Numerical Finding List1
Bulletin 2025–47

Announcements:
2025-19, 2025-29 I.R.B. 191
2025-20, 2025-31 I.R.B. 271
2025-21, 2025-32 I.R.B. 312
2025-24, 2025-36 I.R.B. 359
2025-25, 2025-36 I.R.B. 360
2025-26, 2025-40 I.R.B. 444

Notices:
2025-32, 2025-27 I.R.B. 1
2025-33, 2025-27 I.R.B. 4
2025-34, 2025-27 I.R.B. 6
2025-35, 2025-27 I.R.B. 8
2025-31, 2025-28 I.R.B. 14
2025-36, 2025-30 I.R.B. 192
2025-37, 2025-30 I.R.B. 198
2025-40, 2025-31 I.R.B. 266
2025-39, 2025-32 I.R.B. 308
2025-28, 2025-34 I.R.B. 316
2025-41, 2025-34 I.R.B. 325
2025-42, 2025-36 I.R.B. 351
2025-43, 2025-36 I.R.B. 356
2025-44, 2025-37 I.R.B. 386
2025-45, 2025-37 I.R.B. 388
2025-38, 2025-38 I.R.B. 392
2025-47, 2025-40 I.R.B. 441
2025-51, 2025-41 I.R.B. 448
2025-52, 2025-41 I.R.B. 474
2025-54, 2025-41 I.R.B. 479
2025-46, 2025-43 I.R.B. 533
2025-50, 2025-43 I.R.B. 542
2025-53, 2025-43 I.R.B. 624
2025-55, 2025-43 I.R.B. 625
2025-49, 2025-44 I.R.B. 627
2025-57, 2025-45 I.R.B. 692
2025-61, 2025-45 I.R.B. 693
2025-63, 2025-46 I.R.B. 709
2025-65, 2025-47 I.R.B. 717

Revenue Procedures:
2025-22, 2025-30 I.R.B. 200
2025-24, 2025-31 I.R.B. 273
2025-25, 2025-32 I.R.B. 311
2025-26, 2025-33 I.R.B. 315
2025-28, 2025-38 I.R.B. 393
2025-30, 2025-42 I.R.B. 489
2025-27, 2025-44 I.R.B. 646
2025-32, 2025-45 I.R.B. 695

Revenue Rulings:
2025-13, 2025-28 I.R.B. 11
2025-14, 2025-32 I.R.B. 300
2025-15, 2025-32 I.R.B. 302
2025-16, 2025-35 I.R.B. 342
2025-17, 2025-36 I.R.B. 349
2025-18, 2025-37 I.R.B. 365
2025-19, 2025-41 I.R.B. 445
2025-20, 2025-41 I.R.B. 447
2025-21, 2025-45 I.R.B. 690

Treasury Decisions:
10021, 2025-31 I.R.B. 264
10031, 2025-32 I.R.B. 304
10033, 2025-40 I.R.B. 411
10035, 2025-42 I.R.B. 484
10034, 2025-43 I.R.B. 523
10036, 2025-43 I.R.B. 525

Proposed Regulations:
REG-125710-18, 2025-30 I.R.B. 263
REG-107459-24, 2025-32 I.R.B. 313
REG-132805-17, 2025-35 I.R.B. 342
REG-108822-25, 2025-36 I.R.B. 361
REG-129260-16, 2025-39 I.R.B. 410
REG-108673-25, 2025-42 I.R.B. 494
REG-110032-25, 2025-42 I.R.B. 495
REG-112261-24; REG-116085-23, 2025-42
I.R.B. 522
REG-109742-25, 2025-46 I.R.B. 712

A cumulative list of all revenue rulings, revenue procedures, Treasury decisions, etc., published in Internal Revenue Bulletins 2025–27 through 2025–52 is in Internal Revenue Bulletin
2025–52, dated December 22, 2025.
1

November 17, 2025

ii

Bulletin No. 2025–47

Finding List of Current Actions on
Previously Published Items1
Bulletin 2025–47

A cumulative list of all revenue rulings, revenue procedures, Treasury decisions, etc., published in Internal Revenue Bulletins 2025–27 through 2025–52 is in Internal Revenue Bulletin
2025–52, dated December 22, 2025.
1

Bulletin No. 2025–47

iii

November 17, 2025

Internal Revenue Service
Washington, DC 20224
Official Business
Penalty for Private Use, $300

INTERNAL REVENUE BULLETIN

The Introduction at the beginning of this issue describes the purpose and content of this publication. The weekly Internal Revenue
Bulletins are available at www.irs.gov/irb/.

We Welcome Comments About the Internal Revenue Bulletin

If you have comments concerning the format or production of the Internal Revenue Bulletin or suggestions for improving it,
we would be pleased to hear from you. You can email us your suggestions or comments through the IRS Internet Home Page
www.irs.gov) or write to the Internal Revenue Service, Publishing Division, IRB Publishing Program Desk, 1111 Constitution Ave.
NW, IR-6230 Washington, DC 20224.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/agency%3Airs%3A15c482d5ef91b6b4. Public record. Not legal advice.