Submitted by Matthew.Gregor… on Mon, 11/04/2019 - 07:39
Regulation No.
Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2016
Publication Date

This rule can be downloaded from here - CMS-1624-F.

The associated files to this rule, as described below, can be downloaded from here - FY 2016 IRF PPS Final Rule Data Files (ZIP)

  • IRF Rate Setting Final Rule 
    This file contains data for each of the 1,135 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient rehabilitation prospective payment system regulation. The methodology used to update the payment data is described in detail in the final rule.
  • Case-Mix Groups, Relative Weights, and Average Length Of Stay Values used in the final rule (80 FR 47142) and the standard deviations from the average lengths of stay.
  • IRF Wage Index Final Rule 
    These files contain the urban and rural Core-Based Statistical Area FY 2016 IRF wage index tables.
  • Tier Comorbidities – ICD-10-CM 
    This file contains the list of diagnoses (ICD-10-CM codes) that are used to determine placement in tiers for IRF discharges, effective October 1, 2015. It contains the ICD-10-CM codes, the abbreviated code labels, the appropriate tier, and any RICs for which the ICD-10-CM codes are excluded from the tiers. (Unchanged from the revised file posted on 4-15-2015.)
  • List of IRFs Receiving the Phase-Out of the Rural Adjustment 
    This file contains a list of the Medicare provider numbers and names of the 19 inpatient rehabilitation facilities that are transitioning from rural to urban status, and will therefore receive 2/3 of the 14.9 percent rural adjustment for FY 2016, as described in more detail in the final rule.  
  • ICD-9-CM to ICD-10-CM Code Translation and the Use of Combination Codes in the IRF PPS
    This file contains a document that outlines the use of combination diagnosis codes in the IRF PPS for the following ICD-10-CM code lists: Tier Comorbidities, Codes That Meet Presumptive Compliance Criteria, and Impairment Group Codes That Meet Presumptive Compliance Criteria.