Medicare IRF PPS Final Rule
On August 8, 2008, CMS published its Medicare inpatient rehabilitation facility (IRF) PPS rule for FY 2009. While the rule provides a freeze in the standard federal rate as required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), CMS estimates that the rule will cut IRF payments by $40 million, or 0.7%, for FY 2009, primarily due to an increase in the outlier payment threshold amount to $10,250. As required by the MMSEA, the final rule retains the requirement that at least 60% of a facility’s patient population have one of 13 qualifying conditions, and CMS will continue to count comorbidities under certain conditions when determining an IRF’s compliance with the threshold. The rule also, among other things, updates the case mix group relative weights, average length of stay values, and wage index tables. The updated IRF PPS rates are applicable for discharges on or after October 1, 2008 and on or before September 30, 2009.
