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

The Centers for Medicare and Medicaid Services (CMS) has announced that the Inpatient Rehabilitation Facility (IRF) Provider Preview Reports have been updated and are now available. Per CMS, “the data contained within the Preview Reports is based on quality data submitted by IRFs between Quarter 2 – 2018 and Quarter 1 – 2019 and reflects what will be published on IRF Compare during the December 2019 refresh of the website”. Providers will have until October 11, 2019 to review their data and can request CMS review of their data during the preview period if they believe the quality measure scores

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

On December 20, 2018, the Centers for Medicare and Medicaid Services (CMS) revised MLN Matters Number SE 17036 to remove the Admission order requirement from the portion of the article under “Required documentation elements for an IRF claim include, but are not limited to.” To access this ML Matters revision, click HERE. In addition, CMS did clarify the use of students treating Medicare beneficiaries in the inpatient rehab setting. For the latest information on this topic, click HERE.

During a November 15, 2018 Inpatient Rehabilitation Facility (IRF) phone call, a Centers for Medicare and Medicaid Services (CMS) representative stated that according to hospital conditions of participation that Inpatient Rehabilitation Facilities (IRFs) must meet, students do not have a role in providing therapy or therapy minutes to patients, even under direct supervision of the licensed therapist. On December 11, 2018, the American Physical Therapy Association (APTA), American Occupational Therapy Association, and American Speech-Language-Hearing Association participated in a meeting with CMS. During the meeting, CMS indicated that there had been