CMS Clarifies IRF Claim Processing


CMS published revisions to the inpatient rehabilitation facility (IRF) section of the Medicare Claims Processing Manual (Chapter 3, Section 140 of Pub. 100-04) in Transmittal 2638 [PDF] on January 18, 2013. According to CMS, the changes are intended only to clarify existing IRF payment policies. The changes address the following issues:

  • IRF classification requirements
  • Criteria for inpatient rehabilitation units
  • Verification process used to determine if IRF meets classification criteria
  • New IRFs
  • Changes in the status of an IRF unit
  • New IRF beds
  • Change of ownership or leasing
  • IRF mergers
  • Full time equivalent resident cap
  • Outlier payments

The related provider education article (MLN Matters Number: MM8127) can be accessed here [PDF]. The effective date of the revised manual provisions is April 22, 2013.


Written by:

Published In:


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.

© Ober|Kaler | Attorney Advertising

Don't miss a thing! Build a custom news brief:

Read fresh new writing on compliance, cybersecurity, Dodd-Frank, whistleblowers, social media, hiring & firing, patent reform, the NLRB, Obamacare, the SEC…

…or whatever matters the most to you. Follow authors, firms, and topics on JD Supra.

Create your news brief now - it's free and easy »

All the intelligence you need, in one easy email:

Great! Your first step to building an email digest of JD Supra authors and topics. Log in with LinkedIn so we can start sending your digest...

Sign up for your custom alerts now, using LinkedIn ›

* With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name.