Inpatient Rehabilitation - Resources

Rehabilitation Services- Resource Index

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CMS Hosting IRF Quality Training on May 12: This day-long training is specific to the new Quality Indicator Section items of the 2014 IRF-PAI version 1.2, and to reporting of the Health Care Worker Influenza Vaccination data. Options to participate are in person, by live web stream, or download and view at your own convenience. Registration for on-site attendance at the CMS complex will be open until 11:50 PM ET on Monday May 5, 2014. See the announcement for more details.

Moran Report: Utilization Trends in Inpatient Rehabilitation: Update through Q2: 2012

Press Release: New Report Confirms Declining Utilization and Increasing Acuity of Inpatient Rehabilitation Hospital Services Provided to Seniors

Moran Report: Utilization Trends in Inpatient Rehabilitation: Update Through Q2: 2011

Access to Medical Care for Persons with Mobility Disabilities, a guide to help health care providers understand the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.

Rehab Hospitals Retooling, Joe Cantlupe for HealthLeaders Media, April 25, 2011

CMS has also posted the long-awaited IRF Report to Congress: Analysis of the Classification Criteria for Inpatient Rehabilitation Facilities. In 2007, Congress directed CMS to develop a Report to Congress providing an analysis of Medicare beneficiaries' access to medically necessary rehabilitation services, including the potential effect of the 75 percent rule (now known as the "60 percent rule") on access to care; on alternatives or refinements to the "60 percent rule" policy for determining criteria for inpatient rehabilitation hospital or unit designation under the Medicare program; and an analysis of the conditions for which individuals are commonly admitted to inpatient rehabilitation hospitals that are not included as a condition formerly described in section 412.23(b)(2)(iii) (redesignated as 412.23(b)(2)(ii) in the FY 2009 IRF PPS final rule (73 FR 46370 at 46391 through 46392)) of title 42, Code of Federal Regulations, to determine the appropriate setting of care, and any variation in patient outcomes and costs, across settings of care, for treatment of such conditions. This report, which was prepared by the Research Triangle Institute International under contract with CMS, has been submitted to Congress in response to the requirements of section 115(c) of the MMSEA. It is accessible on the CMS IRF PPS web site in the research section at

CMS Special Open Door Forum on August 19: Developing Outpatient Therapy Payment Alternatives (DOTPA)
CMS and its data collection contractor, RTI International, explained the critical role of providers in this research. Medicare is now actively seeking providers to participate as data collection sites. An audio recording and transcript of this Special ODF is posted to the Special ODF website at

OIG Reports:

The OIG estimates that Medicare overpaid inpatient rehabilitation facilities $34 million in fiscal years 2004 through 2007 for claims miscoded under the program's transfer policy. (June 29, 2010)

The OIG found that IRFs received an estimated $20 million in Medicare overpayments in 2006 and 2007. (June 9, 2010)

News Summary: Large Multi-center Study on Joint Replacement Rehabilitation Finds that Hospital-based Rehabilitation Centers Provide Modestly Better Outcomes,
Study's Medium-volume Skilled Nursing Facilities also Perform Well
(September 2, 2009)

OIG report: Review of Interrupted Stays at Inpatient Rehabilitation Facilities. This report estimates that Medicare overpaid IRFs by $4.2 million for incorrectly billed interrupted stays during 2004 and 2005 and recommends recovery of these payments. (April 2009)

Limiting Access to Inpatient Medical Rehabilitation: A Look at Payment Denials for Medicare Patients Treated in Inpatient Rehabilitation Facilities (October 3, 2007)

Appealing Medicare Claims Determinations

American Academy of Physical Medicine & Rehabilitation Medical Inpatient Rehabilitation Criteria Task Force recommendations for assessing medical appropriateness criteria for admission to rehabilitation hospitals or units
(August 2006)

Lewin Report: Evaluation of the Proposed Coding Adjustment to the Standardized Payment Amount for FY 2007 (July 6, 2006)