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Regulation No.
CMS-1688-F
Title
Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019
Year
2019
Publication Date
2018-08-06

This rule can be viewed from here:  CMS-1688-F

The associated files to this rule, as described below, can be downloaded from here:  FY 2019 Final Rule Data Files

  • IRF Rate Setting Final Rule
    This file contains data for each of the 1,126 inpatient rehabilitation facilities used to estimate the policy updates in the 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 and the standard deviations from the average lengths of stay.
  • Provider Specific Impact Analysis - This file contains the unadjusted estimated payment impacts for providers due to the case-mix classification revisions that will be effective in FY 2020, as described in the FY 19 IRF PPS Final Rule.  
  • IRF Wage Index Final Rule 
    These files contain the proposed urban and rural Core-Based Statistical Area FY 2019 IRF wage index tables.
  • Tier Comorbidities – ICD-10-CM (Updated 8-01-2018) 
    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, 2018. 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. (Updated to reflect ICD-10-CM coding updates for October 1, 2018)
  • Tier Comorbidities Changes 
    This file contains the list of diagnoses (ICD-10-CM codes) that have been added and/or removed from the tier comorbidities. (For ICD-10-CM coding updates, see https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html)
  • Presumptive Compliance-3 (ICD-10-CM) – Updated 8-01-2018 
    This file contains the list of diagnoses (ICD-10-CM codes) that are used for determining presumptive compliance with the IRF 60 percent rule, effective for discharges beginning on or after October 1, 2018. (Updated to reflect ICD-10-CM coding updates for October 1, 2018)
  • Presumptive Compliance Changes 
    This file contains the list of diagnoses (ICD-10-CM codes) that have been added and/or removed from the list of diagnoses codes used for determining presumptive compliance with the IRF 60 percent rule. (For ICD-10-CM coding updates, see https://www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-CM.html).
  • Impairment Group Codes That Meet Presumptive Compliance Criteria-3 (ICD-10-CM) 
    This file contains the list of impairment group codes that are used for determining presumptive compliance with the IRF 60 percent rule, effective for discharges beginning on or after October 1, 2018. (There are no ICD-10-CM coding updates to this file for October 1, 2018)