CMS Seeks Input From Physicians and Practices on Impact of Prior Authorization
August 28, 2019
CMS Issues Final Rule on Inpatient Prospective Payment System
August 28, 2019

On July 31, CMS issued a final rule that updates Medicare payment policies and rates for facilities under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program for fiscal year 2020. CMS is continuing ts efforts toward the eventual transition to a unified post-acute care system through updates to the data used for IRF payments, including revising the Case-Mix Groups (CMGs), updating the CMG relative weights and average length of stay values, and using concurrent inpatient prospective payment system wage index data for the IRF PPS to align wage index data across settings of care.

For fiscal year 2020, CMS is finalizing updates to the IRF PPS payment rates using the most recent data to reflect an estimated 2.5 percent increase factor (reflecting an IRF-specific market basket increase factor of 2.9 percent, reduced by a 0.4 percentage point multifactor productivity adjustment). CMS projects that IRF payments will increase by 2.5 percent (or $210 million) for fiscal year 2020, relative to payments in fiscal year 2019.

This Rule finalizes:

  • rebase and revise the IRF market basket
  • clarification of “rehabilitation physician”
  • two new quality measures

The changes go into effect Oct. 1 and will remain in effect until Sept. 30, 2029.

To read the full text of final rule, click here.

To read the fact sheet on final rule, click here.