Inpatient Rehabilitation PPS

In a broad sense, rehabilitation services are measures taken to promote optimum attainable levels of physical, cognitive, emotional, psychological, social, and economic usefulness, and thereafter to maintain the individual at the maximal functional level.

The term is used to denote services provided in inpatient and outpatient settings, ranging from comprehensive coordinated medically based programs in specialized hospital settings to therapies offered in units of hospitals, nursing facilities, or ambulatory centers. Resources found on this site mainly focus on Medicare payment and related implementation issues.

Medicare’s Inpatient Rehabilitation Facility Prospective Payment System

On August 7, 2001, the Centers for Medicare & Medicaid Services (CMS) published a prospective payment system (PPS) for Medicare Inpatient Rehabilitation Facilities (IRF) as required by the Balanced Budget Act of 1997 (BBA). The payment system that became effective on January 1, 2002, significantly changed how inpatient medical rehabilitation hospitals and units are paid under Medicare. The payment system uses a streamlined patient assessment instrument (the IRF PAI), which incorporates functional independence and case mix measures. This site provides information and resources relative to the implementation, review, and operation of primarily hospital-based medical rehabilitation services.

Related Resources

Special Bulletin
Member
The Centers for Medicare…
Letter
Public
The AHA appreciates the extensive work CMS has done to develop and alternative to the current SNF case-mix system. However, our evaluation of the patient-…
Webinar Recordings
Member
The Centers for Medicare & Medicaid Services recently released the FY 2019 proposed rules for long-term care hospitals, inpatient rehabilitatio
Advisory
Member
CMS published its fiscal year (FY) 2019 proposed rule for the inpatient rehabilitation facility (IRF) prospective payment system (PPS). Comments on the…
Webinars
As our member hospitals and health systems continue to look for new ways to address the challenges of affordability and to promote value in the pub
Special Bulletin
Member
The CMS April 27 issued proposed rules for the inpatient rehabilitation facility and skilled-nursing facility prospective payment systems for fiscal year 2019.