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CMS Issues Inpatient Rehabilitation Facility PPS Final Rule for 2021

For CFOs, COOs, post-acute care & rehabilitation leaders

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the federal fiscal year (FFY) 2021 inpatient rehabilitation facility (IRF) prospective payment system (PPS). In the rule, CMS finalizes a 2.8% increase (or $280 million) in payments to IRFs, reflecting a 2.4% market-basket increase, and a 0.4% increase in outlier payments.

Notably, no productivity adjustment was applied this year, due to the disruption caused by the COVID-19 pandemic.   

In response to comments from the field, CMS significantly scaled back its proposed expansion that would have allowed non-physician practitioners to serve as substitutes for rehabilitation physicians. In the final rule, CMS continues to require that the rehabilitation physician review and concur with the pre-admission screening, establish the plan of care, and conduct the weekly interdisciplinary team conferences. Non-physician practitioners may conduct one of the three required weekly visits currently provided by the rehabilitation physician. Additionally, the rule permanently removes the post-admission physician evaluation requirement, which has been waived in response to the COVID-19 pandemic.    

CHA is providing members a summary, prepared by Health Policy Alternatives. The provisions of the final rule become effective Oct. 1.