Medicare Proposes Updates to the Inpatient Rehabilitation Prospective Payment System for Fiscal Year 2025

The Centers for Medicare & Medicaid Services (CMS) have proposed a modest payment increase of 2.8% for inpatient rehabilitation facilities (IRFs) in fiscal year 2025.

CMS also proposes adding new assessment items to the IRF Patient Assessment Instrument (PAI) to capture additional data on social determinants of health (SDOH), including:

• One item to capture information about living situations
• Two items about food insecurity
• One item about the ability to cover utility expenses.

It also proposes to modify an existing SDOH assessment item associated with transportation.

What's Next

The Improving Post-Acute Care Transformation (IMPACT) Act requires standardized items across post-acute care assessment tools. So these assessment items will likely be proposed in the home health, skilled nursing, and long-term care hospital proposed rules, which are expected in the spring or early summer.

ASHA is reviewing the provisions of the proposed rule and will submit comments to CMS. If finalized, these policies would impact payment for services provided on or after October 1, 2024 (the beginning of the federal fiscal year).

Questions?

Email reimbursement@asha.org.