An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg

CMS Finalizes Inpatient Rehabilitation Facility FY 2023 PPS Update

The Centers for Medicare and Medicaid Services (CMS) have issued a final rule to update the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) for FY 2023. 
CMS is basically adopting the provisions set forth in the FY 2023 IRF PPS 
proposed rule specifically CMS is: 

  • Updating the Case-Mix Group (CMG) relative weights and average length of stay (ALOS) values. (Page 15) 
  • Updating the IRF PPS payment rates. (Page 15) 
  • Adopting a permanent cap policy in order to smooth the impact of year-to-year changes in IRF payments related to certain changes to the IRF wage index. (Page 44) 
  • Calculating the IRF standard payment conversion factor. (Page 51) 
  • Updating the outlier threshold amount. (Page 57) 
  • Updating the cost-to-charge ratio (CCR) ceiling and urban/rural average CCRs. (Page 62) 
  • Codifying existing teaching status adjustment policy and is clarifying and updating the IRF teaching status adjustment policy with respect to IRF hospital closures and displaced residents. (Page 66 and 68) 
  • Adopting updates to the IRF QRP beginning with FY 2026. (Page 80) 

The 150-page document is scheduled for publication in the Federal Register on August 1. A copy is currently available at: https://public-inspection.federalregister.gov/2022-16225.pdf.

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