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Last Modified: 3/27/2018 Location: FL, PR, USVI Business: Part A

Prospective payment system (PPS) for inpatient rehabilitation facilities (IRFs)

Section 4421 of the Balanced Budget Act (BBA) of 1997 (Public Law 105-33), as amended by section 125 of the Medicare, Medicaid, and SCHIP, Balanced Budget Refinement Act of 1999 (Public Law 106-113), and by section 305 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA)of 2000 (Public Law 106-554), authorizes the implementation of a per-discharge on PPS, through section 1886(j) of the Social Security Act, for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs). The IRF PPS will utilize information from a patient assessment instrument (IRF PAI) to classify patients into distinct groups based on clinical characteristics and expected resource needs. Separate payments are calculated for each group, including the application of case and facility level adjustments.
Please refer to the CMS website for additional information on IRFs external link.
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