Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
On April 3, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for fiscal year (FY) 2024. CMS is publishing this proposed rule in accordance with the legal requirements to update Medicare payment policies for IRFs on an annual basis.
For FY 2024, CMS is proposing to update the IRF PPS payment rates based on the proposed IRF market basket update, less a proposed productivity adjustment. The proposed rule includes annual updates to the prospective payment rates, the outlier threshold, the case-mix-group relative weights and average length of stay values, the wage index, and associated impact analysis. In addition, the rule includes a proposal to revise and rebase the IRF market basket, as well as a proposal to modify its regulations to allow hospitals to open and begin billing Medicare for an excluded IRF unit anytime within the cost reporting year.
CMS is also proposing two new and one modified measure proposals for the IRF Quality Reporting Program (QRP). In addition, CMS is proposing three measure removals and is proposing one public reporting policy.
This Fact Sheet discusses the provisions of the proposed rule. The FY 2024 Inpatient Rehabilitation Facility Prospective Payment System proposed rule (CMS-1781-P) can be downloaded from the Federal Register at https://www.federalregister.gov/public-inspection/2023-06968/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal.