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

 CMS Finalizes Inpatient Rehabilitation Facility FY 2024 PPS Update  

 The Centers for Medicare and Medicaid Services (CMS) have released a final rule to update the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) for FY 2024. 
A copy of the 279-page document is available at: https://public-inspection.federalregister.gov/2023-16050.pdf. The rule is scheduled for publication in the Federal Register on August 2. 

Policy changes and updates include the following: 

  • Updating the prospective payment rates for IRFs for FY 2024 (that is, for discharges occurring on or after October 1, 2023, and on or before September 30, 2024). 
  • Updating the Classification and weighting factors for the IRF PPS’s case-mix groups (CMGs). 
  • A description of the methodologies and data used in computing the prospective payment rates. 
  • Rebasing and revising the IRF market basket to reflect a 2021 base year. 
  • Confirms when an IRF unit can be excluded and paid under the IRF PPS. 

CMS is also updating the IRF QRP and request information as follows:

  • Modifying the COVID-19 Vaccination Coverage among Healthcare Personnel measure beginning with the FY 2025 QRP and adopting the Discharge Function Score measure. 
  • Removing the Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function measure beginning with the FY 2025 QRP 
  • Removing the Functional Outcome Measure: Change in Self-Care Score for Medical Rehabilitation Patients (NQF #2633) measure beginning with the FY 2025 QRP 
  • Remove the IRF Functional Outcome Measure: Change in Mobility Score for Medical Rehabilitation Patients (NQF #2634) measure beginning with the FY 2025 QRP 
  • Adopting the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measure beginning with the FY 2026 QRP 
  • Requesting information on principles for selecting and prioritizing IRF quality measures and concepts 
  • Providing an update on CMS’ continued efforts to close the health equity gap The IRF 

prospective payment system (IRF PPS) Addenda along with other supporting documents and tables referenced in this final rule are available through the Internet on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS

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