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    Proposed CMS 2015 Payment Rules for Inpatient Rehabilitation Include 2.2% Increase

    Inpatient Rehabilitation Facilities (IRFs) will receive an additional $160 million in 2015, according to policy updates recently released by the US Centers for Medicare and Medicaid Services (CMS). In addition to the payment changes, the updates from CMS also make refinements to compliance lists, expand definitions of therapy, add new outcome measures, and create a new section on the patient assessment instruments (PAIs) for IRFs.

    The change to IRF payments amount to a 2.2% increase. The CMS changes will also:

    • Refine the presumptive compliance list for the 60% rule to remove diagnosis codes that solely focus on amputations
    • Provide definitions for individual therapy (1 therapist to 1 patient), group therapy (1 therapist to 2-6 patients performing same or different activities) and co-treatment (more than 1 therapist from different disciplines to 1 patient)
    • Create a new therapy information section on the IRF-PAI to record the number of individual, group, and co-treatment minutes for each therapy discipline for a 7-day period
    • Add an item to the IRF-PAI to record arthritis diagnoses that meet IRF severity and prior treatment requirements
    • Add 2 new outcomes to the IRF Quality Reporting Program for 2017 payment adjustments for noncompliance: Staphylococcus aureus and Clostridium difficile

    The proposed rule is on display at the Federal Register, and comments will be accepted until June 30, 2014. APTA will provide a detailed summary of the rule shortly and will be submitting comments on behalf of the association.


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