On April 16, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal year (FY) 2021 proposed rule for facilities under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). Highlights of the proposed rule include the following: In the FY 2021 IRF PPS proposed rule, CMS is proposing to allow non-physician practitioners to perform any of the IRF coverage service and documentation duties that are currently required to be performed by a rehabilitation physician, provided that the duties are within the non-physician practitioner’s scope of practice under applicable state law CMS is proposing to no longer require

Due to a recent report by the Office of the Inspector General that found payments for Inpatient Rehabilitation Facility (IRF) services did not comply with Medicare billing requirements, CMS developed the IRF Prospective Payment System booklet as well as additional resources in assisting IRFs become more compliant with IRF billing. To access these resources, click HERE.

On July 31, 2019, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for Fiscal Year (FY) 2020 for Inpatient Rehabilitation Facilities (IRFs). CMS projects that FY 2020 payments to IRF’s will increase by 2.5% compared to FY 2019. In the final rule, highlights of issues addressed by CMS include: Case-Mix Group Revisions (using FY 2017 and FY 2018 data) Rebase and Revise the IRF Market Basket Clarification of “Rehabilitation Physician” Ensuring Quality IRF Quality Reporting Program (QRP) To read a Fact Sheet of the final rule, click HERE. To access the Final Rule, click HERE. I

The Centers for Medicare and Medicaid Services (CMS) has released the fiscal year (FY) 2020 Inpatient Rehabilitation Facility (IRF) proposed rule. Highlights of the proposed rule include: CMS projects that IRF payments will increase by 2.3 percent for FY 2020 Revising the case-mix groups based on two years of data (FY 2017 and FY 2018) from the quality indicator data items and update the relative weights and average length of stay values associated with the revised case-mix groups beginning on October 1, 2019. Proposing 2 new interoperability measures for the IRF rule to implement the final requirements of the IMPACT