Inpatient rehab facilities will get a 2.9{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} pay increase in CMS proposed rule

Inpatient rehabilitation services are getting a payment improve of two.nine{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} for 2021.

Due to the fact of the COVID-19 general public wellness emergency, the Centers for Medicare and Medicaid Products and services in its proposed rule has confined the annual rulemaking to payment and important policies.

CMS is proposing updates to the payment fees working with the most latest knowledge to mirror an believed two.5{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} improve component. This is the inpatient rehabilitation facility market place basket improve component of two.nine{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105}, reduced by a .four{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} multifactor productiveness adjustment.

Having said that, an supplemental .four{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} improve to mixture payments — due to updating the outlier threshold to manage believed outlier payments at 3{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} of complete payments — final results in an general update of two.nine{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105}, or $270 million. 

CMS is also proposing to undertake the most latest Business of Management and Spending plan statistical area delineations and apply a 5{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} cap on wage index decreases from 2020 to 2021.

In an additional go to relieve medical professional stress, CMS is proposing to let non-medical professional practitioners to execute any of the inpatient rehabilitation facility protection company and documentation obligations that are now required to be carried out by a rehabilitation medical professional.

IRFs are generally required to conduct a submit-admission medical professional evaluation in the very first 24 hours of the patient’s admission to ensure that no changes have occurred since the preadmission screening, and that the individual is nevertheless correct for admission to an inpatient rehabilitation facility.

CMS is proposing to no more time need a submit-admission medical professional evaluation since the submit-admission evaluation addresses substantially of the very same info and continues to be involved in the pre-admission screening of the individual and the patient’s program of treatment.  

IRFs, in session with the patient’s medical professional or other managing clinician, would nevertheless have the flexibility to conduct individual visits in the very first 24 hours of an admission if the patient’s condition warrants it.

CMS is proposing no changes to the inpatient rehabilitation facility top quality reporting method.


Owing to the COVID-19 general public wellness emergency, health care companies have confined potential to review and deliver opinions on extensive proposals, CMS said.

CMS is also soliciting opinions from stakeholders on even further ideas to decrease service provider stress, as very well as on proposals to codify subregulatory guidance on preadmission screening documentation and specified other IRF protection requirements.

CMS will settle for opinions until finally June 15.

THE Larger Pattern

CMS has lately issued an array of short term regulatory waivers and new policies to give companies highest flexibility to respond to the COVID-19 pandemic.

This involves waiving the 60{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} rule that necessitates each and every IRF to discharge at minimum 60{d5f2c26e8a2617525656064194f8a7abd2a56a02c0e102ae4b29477986671105} of its individuals with 1 of 13 qualifying conditions.

New flexibility also makes it possible for the required confront-to-confront medical professional visits in IRFs to be performed working with telehealth.

The IRH proposed rule is 1 of 5 proposed Medicare payment policies launched in a fiscal 12 months cycle to outline payment and coverage for inpatient hospitals, extended-expression treatment hospitals, inpatient rehabilitation services, inpatient psychiatric services, skilled nursing services and hospices.

Twitter: @SusanJMorse
E-mail the author: [email protected]