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 viewed from here: CMS-1624-P

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

  • IRF Rate Setting Proposed Rule 
    This file contains data for each of the 1,132 inpatient rehabilitation facilities used to estimate the proposed policy updates in the proposed inpatient rehabilitation prospective payment system regulation. The proposed methodology used to update the payment data is described in detail in the proposed rule.
  • Case-Mix Groups, Relative Weights, and Average Length Of Stay Values used in the proposed rule (80 FR 23332) and the standard deviations from the average lengths of stay.
  • IRF Wage Index Proposed 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 when ICD-10-CM becomes the required medical data code set for use on Medicare claims and IRF-PAI submissions. 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. 4-15-2015 – This file has been revised to make the following corrective edits:
    • Code K25.1 - Choice A - Code Title:  Acute duodenal ulcer with perforation
    • Code K56.60 - Choice B - Code Title:  Unspecified intestinal obstruction
    • Added code G40.411 (the code title is present; the code was inadvertently left off of the list).
    • Deleted one of code G81.93. The code was duplicated in the list.
    • Deleted one of code L03.113. The code was duplicated in the list.
    • Added a letter “B” choice to combination code: