Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) and IRF-PAI Manual

This page includes the current versions of the IRF-PAI, the IRF-PAI Manual, and associated documents. This page will be updated when:

• An update is made to these resources.
• A newer version becomes available.
• Important information regarding these tools needs to be communicated.

The older versions of these documents will remain available for reference in the IRF Quality Reporting Program Archives.

For additional information related to the IRF Prospective Payment System (PPS) requirements, please refer to the IRF PPS webpage.

IRF-PAI

The Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) is the assessment instrument IRF providers use to collect patient assessment data for quality measure calculation and payment determination in accordance with the IRF Quality Reporting Program (QRP). Completion of the IRF-PAI is required for each Medicare Part A fee-for-service and Medicare Part C patient discharged from an IRF. Beginning October 1, 2024, completion of the IRF-PAI will be required for all patients, regardless of payer. For more information about data collection and submission for the QRP, please refer to the IRF Quality Reporting Data Submission Deadlines webpage.

IRF-PAI Manual

The purpose of the IRF-PAI Manual is to offer continuing guidance to IRFs regarding collection, submission, and reporting of assessment data. The IRF-PAI Manual offers item-by-item coding instructions and coding examples for each item to assist IRF staff to accurately complete the IRF-PAI. The most recent version of the IRF-PAI Manual is available in the Downloads section below.

Updates

December 16, 2024

CMS IRF-PAI Quarterly Q&As, December 2024, Consolidated June 2020 to December 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, in December of 2024. The document contains the consolidated Q&As from June 2020 to December 2024 so that all IRF providers have the benefit of clarifications to existing guidance, CMS identifies the opportunity to clarify or refine guidance.

The Quarterly Q&A document is available in the Downloads section of this webpage.

September 3, 2024

CMS IRF-PAI Quarterly Q&As, September 2024, Consolidated June 2020 to September 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, in September of 2024. The document contains the consolidated Q&As from June 2020 to September 2024 so that all IRF providers have the benefit of clarifications to existing guidance. Through inquiries to the IRF Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS identifies the opportunity to clarify or refine guidance. 

The Quarterly Q&A document is available in the Downloads section of this webpage.

June 18, 2024

CMS IRF-PAI Quarterly Q&As, June 2024, Consolidated June 2020 to June 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, in June of 2024. The document contains the consolidated Q&As from June 2020 to June 2024 so that all IRF providers have the benefit of clarifications to existing guidance. Through inquiries to the IRF Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS identifies the opportunity to clarify or refine guidance. 

The Quarterly Q&A document is available in the Downloads section of this webpage.

March 20, 2024

CMS IRF-PAI Quarterly Q&As, March 2024, Consolidated June 2020 to March 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, in March of 2024. The document contains the consolidated Q&As from June 2020 to March 2024 so that all IRF providers have the benefit of the clarifications to existing guidance. Through inquiries to the IRF Post-Acute Care (PAC) Quality Reporting Program (QRP) Help Desk, CMS identifies the opportunity to clarify or refine guidance. While no new Q&As were added to the consolidated document for this release, CMS has archived some Q&As either because the guidance has been added to the IRF-PAI 4.2 Manual, or the Q&As have been retired.

The Quarterly Q&A document is available in the Downloads section of this webpage.

February 1, 2024

CMS IRF-PAI Manual Version 4.2 

The Centers for Medicare & Medicaid Services (CMS) is publishing the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Manual, Version 4.2, effective October 1, 2024. A Change Table outlining the revisions to the CMS IRF-PAI Manual Version 4.2 is also published.

The Manual and Change Table is available in the Downloads section of this webpage.