CMS Releases IRF PPS Final Rule

CMS Releases IRF PPS Final Rule

On July 31, CMS released the FY 2020 IRF PPS Final Rule.

Highlights include:

      • 2.5% payment update (~$210 million)
      • Removal of the Functional Independence Measure (FIM™) items from the IRF patient assessment instrument beginning October 1, 2019
      • Finalized the use of certain “quality indicator data items” (i.e., Section GG mobility and self-care items) for payment purposes beginning October 1, 2019
      • Finalized revisions to the case-mix groups (CMGs), including the use of an unweighted motor score to “ease provider’s transition” to the use of Section GG. (Note: CMS had proposed to weight the motor score, but that was not finalized.)
      • Changes to the IRF Quality Reporting Program (QRP) including adoption of two new Transfer of Health Information measures, adoption of several standardized patient data elements (SPADEs) that will improve coordination and communication between post-acute providers, and updating of the specifications of the Discharge to Community PAC IRF measure to exclude baseline nursing facility residents. (Note: These are the same QRP updates included in the FY 2020 SNF PPS Final Rule and the CY 2020 HH PPS Proposed Rule.)

The CMS Fact Sheet can be accessed here.

The Final Rule can be accessed here.

Holly Hester

Holly Hester is Casamba’s Senior Vice President of Compliance & Education, as well as the Compliance Officer. She provides regulatory guidance and interpretation, clinical programming and content development, education and training steerage, and compliance support for the company. As a physical therapist for more than 20 years, Holly has multi-venue clinical and management experience, giving her a unique perspective on the integration of compliance and training with therapy service delivery and clinical practice.
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