August 7, 2014

CMS Issues Final Rule for FY2015 IRF PPS

On July 31, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating fiscal year (FY) 2015 Medicare payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the IRF Quality Reporting Program (IRF QRP).  CMS estimates that aggregate payments to IRFs will increase in FY2015 by $180 million, or 2.4 percent, relative to payments in FY2014. CMS will freeze the facility-level adjustment factors for FY2015 and subsequent years at the FY2014 levels, as they work to monitor the most current IRF data available and evaluate the effects of the FY2014 changes.


In the rule, CMS is finalizing some additional revisions to the comorbidity, impairment group codes and etiologic diagnosis portions of the presumptive compliance methodology to be consistent with the changes implemented in the FY2014 final rule.  In response to public comments, this final rule delays the effective date for the revisions to the presumptive compliance codes finalized in the FY2014 IRF PPS final rule and the changes finalized in this rule until compliance review periods beginning on or after Oct. 1, 2015. CMS is also adding a new item to the patient assessment that requires IRFs to record how much and what type of therapy (i.e. Individual, Group, Concurrent, and Co-Treatment) patients receive in each therapy discipline (i.e. physical therapy, occupational therapy, and speech-language pathology). CMS will require IRFs to record the total number of therapy minutes received by mode and discipline only for weeks one and two of the IRF stay and will require "Concurrent Therapy" to be reported as a separate category from "Group Therapy." This requirement will become effective for IRF discharges occurring on or after Oct. 1, 2015.


Questions? Contact Kathy Reep, vice president of financial services, at (407) 841-6230.