Inpatient Rehabilitation Facility PPS Payments Increase 2.1 Percent for FY 2013


CMS’s notice updating the inpatient rehabilitation facility (IRF) prospective payment system (PPS) for discharges occurring during FY 2013 was published in today’s Federal Register (July 30, 2012).  IRF PPS payment rates will be increased by an adjusted market basket increase factor of 1.9 percent for FY 2013, which includes a 2.7 percent market basket update less a 0.1 percentage point reduction and a 0.7 percent productivity adjustment mandated by the Affordable Care Act.  In addition to the 1.9 percent net market basket increase, CMS will increase total outlier payments by 0.2 percent for a total estimated increase in payments to IRFs of 2.1 percent.  CMS estimates $140 million in increased payments to IRFs during FY 2013.

In this notice, CMS updates the IRF PPS relative weights, average length of stay values, payment rates, outlier threshold, and cost-to-charge ratio (CCR) ceilings and urban/rural CCRs.  There are no policy changes or regulatory revisions proposed in this notice.  The IRF PPS notice is available by clicking here.

Reporter, Susan Banks, Washington, D.C., +1 202 626 2953,

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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