FY2010 IRF Coverage Criteria in Medicare Regulations

CMS has released the fourth in a series of clarifications on the new IRF coverage

These requirements are now available for download from the Coverage Requirements webpage at http://www.cms.gov/InpatientRehabFacPPS/04_Coverage.asp#TopOfPage. Clarifications cover questions pertaining to admission orders, preadmission screening, post-admission physician evaluation, physician visits, interdisciplinary team meetings, therapy, admissions, individualized overall plan of care, and some technical issues.

CMS’ Materials from the November 12, 2009 Provider Education Call on the IRF Coverage Requirements

IRF Training Call Q&A Clarification

Federal Register

42 CFR Part 412: Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2010; Final Rule

See especially the following two sections:

  • VIII. Inpatient Rehabilitation Facility (IRF) Coverage Requirements (Page 39788)
    A full discussion including: Requirements for the Preadmission Screening; for a Post-Admission Physician Evaluation; for an Individualized Overall Plan of Care; for Evaluating the Appropriateness of an IRF Admission; for the Interdisciplinary Team Meetings; for Physician Supervision; Regarding Initiation of Therapy Services; Provision of Group Therapies in IRFs; Clarifying and Conforming Amendments; and HCFAR 85–2 Ruling.
  • XI. Provisions in the Final Rule; B. Regulatory Text Changes (Page 39802) Short Summary.

AHA Regulatory Advisory

Inpatient Rehabilitation Facility PPS: The Final Rule for FY 2010  (September 04, 2009)

CMS’ Online Clarification of New Regulatory Criteria


Transmittal 112

(CMS Interpretation of the new IRF criteria.  These are CMS’ instructions to their contractors, including Cahaba.)





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