Policy updates released by the Centers for Medicare and Medicaid Services (CMS) show that Inpatient Rehabilitation Facilities (IRFs) will receive an additional $160 million in 2015. In addition to payment changes, the recent CMS updates also make refinements to compliance lists, add new outcome measures, expand definitions of therapy, and create a new section on the patient assessment instruments (PAIs) for IRFs. The change to IRF payments amounts to a 2.2% increase.
According a news release from the American Physical Therapy Association (APTA), the CMS changes also include refining the presumptive compliance list for the 60% rule to remove diagnosis codes that solely focus on amputations. The changes also provide definitions for individual therapy (one therapist to one patient) and group therapy (one therapist to two to six patients performing same or different activities).
Co-treatment is also defined in the changes as more than one therapist from different disciplines to one patient. In addition, the proposed changes create a new therapy information section on the IRF-PAI to record the number of group, individual, and co-treatment minutes for each therapy discipline for a 7-day period, and the ability to add an item to the IRF-PAI to record arthritis diagnoses that meet IRF severity and prior treatment requirements.
The CMS changes will also add two new outcomes to the IRF Quality Reporting Program for 2017 payment adjustments for non-compliance: Staphylococcus aureus and Clostridium difficile.
The APTA news release notes that the proposed rule is on display and is available to view by visiting: www.federalregister.gov/public-inspection. Comments will be accepted until June 30, 2014.