June 19, 2024


Built Business Tough

Inpatient rehab facilities will get a 2.9% pay increase in CMS proposed rule

Inpatient rehabilitation facilities are receiving a payment increase of two.9% for 2021.

For the reason that of the COVID-19 general public health and fitness unexpected emergency, the Facilities for Medicare and Medicaid Expert services in its proposed rule has confined the annual rulemaking to payment and important procedures.

CMS is proposing updates to the payment charges utilizing the most modern knowledge to replicate an estimated two.5% increase component. This is the inpatient rehabilitation facility industry basket increase component of two.9%, lessened by a .four% multifactor efficiency adjustment.

However, an further .four% increase to aggregate payments — due to updating the outlier threshold to preserve estimated outlier payments at 3% of full payments — success in an in general update of two.9%, or $270 million. 

CMS is also proposing to undertake the most modern Business office of Administration and Finances statistical place delineations and use a 5% cap on wage index decreases from 2020 to 2021.

In a different shift to ease doctor load, CMS is proposing to enable non-doctor practitioners to carry out any of the inpatient rehabilitation facility coverage company and documentation duties that are now required to be executed by a rehabilitation doctor.

IRFs are generally required to carry out a write-up-admission doctor analysis within the initial 24 hours of the patient’s admission to confirm that no improvements have occurred because the preadmission screening, and that the affected individual is still acceptable for admission to an inpatient rehabilitation facility.

CMS is proposing to no extended demand a write-up-admission doctor analysis because the write-up-admission analysis covers a great deal of the similar information and carries on to be incorporated in the pre-admission screening of the affected individual and the patient’s approach of care.  

IRFs, in consultation with the patient’s doctor or other dealing with clinician, would still have the flexibility to carry out affected individual visits within the initial 24 hours of an admission if the patient’s issue warrants it.

CMS is proposing no improvements to the inpatient rehabilitation facility quality reporting system.


Thanks to the COVID-19 general public health and fitness unexpected emergency, health care companies have confined ability to overview and offer comments on in depth proposals, CMS reported.

CMS is also soliciting comments from stakeholders on even more thoughts to minimize supplier load, as nicely as on proposals to codify subregulatory advice on preadmission screening documentation and selected other IRF coverage needs.

CMS will take comments until finally June fifteen.

THE Larger sized Trend

CMS has not too long ago issued an array of momentary regulatory waivers and new procedures to give companies optimum flexibility to react to the COVID-19 pandemic.

This consists of waiving the 60% rule that involves every single IRF to discharge at the very least 60% of its individuals with one particular of 13 qualifying conditions.

New flexibility also allows the required confront-to-confront doctor visits in IRFs to be performed utilizing telehealth.

The IRH proposed rule is one particular of 5 proposed Medicare payment procedures released in a fiscal calendar year cycle to determine payment and plan for inpatient hospitals, prolonged-expression care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, competent nursing facilities and hospices.

Twitter: @SusanJMorse
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