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The Internal Revenue Service (IRS) has issued Notice 2025-61, announcing a significant increase to the Patient-Centered Outcomes Research Institute (PCORI) fee amount. Employers with self-insured health plans and health insurance issuers must take note of the new rate and upcoming compliance deadlines.
What is the New PCORI Fee Amount?
The PCORI fee is increasing to $3.84 per covered life. This new rate applies to plan years that end on or after October 1, 2025, and before October 1, 2026.
For comparison, the previous fee amount (for plan years that ended on or after Oct. 1, 2024, and before Oct. 1, 2025) was $3.47 multiplied by the average number of lives covered under the plan.
Background and Applicability
The PCORI fee was originally established by the Affordable Care Act (ACA) to fund comparative effectiveness research. Though initially set to expire in 2019, federal legislation extended the fee for an additional 10 years. The PCORI fee is now scheduled to apply through the plan or policy year ending before October 1, 2029.
The fee is imposed on:
- Health insurance issuers
- Sponsors of self-insured health plans
The fee is calculated based on the average number of covered lives under the plan, which generally includes employees, their enrolled spouses, and dependents (unless the plan is an HRA or FSA).
Reporting and Payment Deadlines
The PCORI fee must be reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return).
The fee is always due by July 31st of the year following the last day of the plan year.
Action for Self-Insured Plans: Employers with self-insured health plans should ensure they use the correct rate and meet the upcoming July 31st deadline corresponding to their plan year end.
Additional Resources: