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The Centers for Medicare and Medicaid Services (CMS) has announced that it has recalculated reimbursement rates for inpatient rehabilitation facilities (IRF) to more accurately reflect the intense rehabilitation services the facilities provide Medicare beneficiaries. Patients receiving services at inpatient rehabilitation facilities are often recovering from serious illnesses, such as stroke. The rates, which become effective October 1, 2008, are part of the IRF final rule which will be published in the August 8, Federal Register.
According to CMS, the payment rates set for rehabilitation therapy services provided in IRFs are higher than what would be paid for services in other settings, such as hospital outpatient departments, skilled nursing facilities, or in home health settings. This is because these patients have more severe and more complex medical conditions that need more intensive and coordinated rehabilitation services.
The final rule also retains the requirement that at least 60 percent of a facility's patient population have 1 of 13 qualifying conditions specified in Medicare regulations. As part of the final rule, CMS will continue to count patients whose principal reason for needing inpatient rehabilitation services is not one of the qualifying conditions, but whose treatment is complicated by the presence of one or more of these conditions, as a secondary diagnosis. For additional information on the IRF final rule, please contact reimbursement@asha.org.
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