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CMS Issues FFY 2021 IRF PPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2021 proposed rule for the inpatient rehabilitation facility prospective payment system, which would update the Medicare payment rate and quality reporting programs. The provisions in the proposed rule, if finalized, would be effective Oct. 1, 2021.

SDAHO is currently reviewing the proposed rule and will provide a brief summary and members in the coming weeks. Comments are due to CMS by 12 p.m. (CST) on June 15.

Payment Provisions  

CMS proposes to increase net payments by 2.9%  —  or $270 million  —  compared to FFY 2020 as a result of a 2.9% market-basket update, offset by a 0.4 percentage point reduction for multifactor productivity adjustment, and increased by a 0.4% increase due to updating the outlier threshold amount.

CMS proposes to adopt revised geographic delineations provided by the Office of Management and Budget, which are used to identify a provider’s status as an urban or rural facility and to calculate the wage index, as well as to cap wage index decreases at 5% .

Regulatory Provisions  

CMS proposes to remove the requirement for the post-admission physician evaluation, and to allow certain non-physician practitioners to complete certain activities and documentation that are currently performed by the rehabilitation physician

For further information, see the IRF center webpage.​


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