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Spotlight

Access educational materials, coverage guidance, and frequently asked questions (FAQs) related to the FY 2027 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) Final Rule:

• Medicare inpatient rehabilitation facility: FY 2027 Final Rule education (PDF)

• IRF: 36-hour requirement (PDF)

• IRF: Initial IDT meeting (PDF)

• IRF: FY 2027 Final Rule frequently asked questions (PDF)

Local Coverage Determination (LCD) / National Coverage Determination (NCD)

LCD

Search for IRF-related LCDs using these available tools:

• LCD interactive index tool
• View First Coast’s active / proposed LCDs / articles on CMS’ Medicare coverage database (MCD)

NCD

• Search CMS’ MCD
• CMS’ MCD - NCD alphabetical index

Medical Documentation

Medical record documentation is used to verify that services were billed correctly and to ensure that payment and processing of Medicare claim(s) are accurate and based on sound policy.  Find information, tips, and resources regarding medical documentation.

Checklist: Inpatient Rehabilitation Facility (IRF)

CMS Internet-Only Manuals (IOM)

The CMS’ IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives. The following CMS IOMs contains information specific to rehabilitation service providers:

• CMS IOM Pub. 100-02  Medicare Benefit Policy Manual, Chapter 1
• CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 3

Resources

Listed below are additional resources identified specifically for inpatient rehabilitation service providers:

• Medicare Provider Compliance Tips: Inpatient Rehabilitation Hospitals & Inpatient Rehabilitation Units
• Inpatient Rehabilitation Facility PPS
• IRF-PAI
• Inpatient Rehabilitation Facility PPS Web Pricer
• Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) 
• Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program
  • Medicare Inpatient Rehabilitation Facility: FY 2027 Final Rule Education (PDF)
  • IRF: 36-Hour Requirement (PDF)
  • IRF: Initial IDT Meeting (PDF)
  • IRF: FY 2027 Final Rule Frequently Asked Questions (PDF)

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