CMS Releases FY 2015 IRF Final Rule

On August 6, 2014, the Centers for Medicare and Medicaid Services (CMS) issued Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2015; Final Rule. Inpatient Rehabilitation Facilities (IRFs) will receive a 2.2% increase in their FY 2015 payments compared to FY 2014. The final rule discusses revisions to the 60 Percent Rule Presumptive Compliance Criteria, definitions of individual therapy, group therapy, co-treatment therapy and concurrent therapy, and revision to the IRF-PAI for arthritis conditions.

Revisions to the 60 Percent Rule Presumptive Compliance Criteria

CMS finalizes its proposal to remove 10 status post-amputation diagnoses codes from the “ICD-9-CM Codes that meet presumptive compliance criteria”. The removal of these codes (see below for ICD-9 codes that have been removed) will be effective for compliance review periods beginning on or after

V52.1 – Fitting and adjustment of artificial leg (complete) (partial)