CMS' proposed inpatient rehabilitation payment rule for 2020: 5 things to know

CMS released its fiscal year 2020 Inpatient Rehabilitation Facility Prospective Payment System proposed rule April 17, which would boost Medicare payments to IRFs.

Five things to know about the proposed rule:

1. Under the proposed rule, payments for IRFs would increase by 2.3 percent, or $195 million.

2. The proposed rule includes details about the revised IRF case mix groups for fiscal 2020, which are based on two years of quality indicator data items.

3. Beginning in fiscal 2020, the proposed rule would update the relative weights and average length of stay values associated with the revised case mix groups based on fiscal 2017 and 2018 data.  

4. The proposed rule includes the classification and weighting factors for the case mix groups and a description of the methodologies used in calculating the prospective payment rates for fiscal 2020.

"We have repeatedly requested that CMS provide as much transparency as is feasible to offer insight into the policy decisions made related to the CMG revisions and we are appreciative that the agency has provided a description of the data and methodologies it used," AHA Executive Vice President Tom Nickels said in a news release.

5. Under the proposed rule, CMS would use concurrent fiscal year Inpatient Prospective Payment System wage index data to update the IRF wage index in fiscal 2020.

Read the proposed rule here.

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