2027 FINAL RULES INPATIENT REHAB
An Analysis and Commentary on Federal Health Care Issues by Larry Goldberg
CMS Finalizes Inpatient Rehabilitation Facility FY 2027 PPS Update
The Centers for Medicare and Medicaid Services (CMS) have issued a final rule that will update the Inpatient Rehabilitation Facilities Prospective Payment System (PPS) for fiscal year (FY) 2027.
As required by section 1886(j)(5) of the Act, the final rule includes the classification and weighting factors for the IRF PPS case-mix groups (CMGs), and a description of the methodologies and data used in computing the prospective payment rates for FY 2027.
In addition, the final rule revises § 412.622(a)(3)(ii) to require all therapy treatments and/or therapy evaluations begin no later than 36 hours from midnight on the day of admission (hereafter referred to as the 36-hour requirement); and finalizes requirements for the initial Interdisciplinary Team (IDT) by revising § 412.622(a)(5) to require the initial meeting to occur on or before 4 days from the date the patient is admitted to align with the Plan of Care (POC) timeframe.
For the IRF Quality Reporting Program (QRP), this final rule revises the IRF QRP data submission deadlines beginning with the FY 2029 IRF QRP. Finally, CMS provides summaries of the comments received in response to an RFI on future measure concepts for the IRF QRP.
For the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP), this rule finalizes a higher bid surety bond amount for a bidding entity submitting a bid in a Remote Item Delivery (RID) competitive bidding area.
The rule is scheduled for publication in the Federal Register on August 3. A copy of the 137-page rule is currently available at: https://public-inspection.federalregister.gov/2026-15652.pdf.