CMS-1748-F

This rule (CMS-1748-F) published on August 4, 2021.

The associated file(s) (ZIP) are described below:

• IRF Wage Index Final Rule (revised 1/26/2022) - These files contain the final urban and rural Core-Based Statistical Area FY 2022 IRF wage index tables.  On 1/26/2022, the missing urban area title for CBSA 35154 (New Brunswick-Lakewood, NJ)  was placed in the table.
• IRF Rate Setting Final Rule - This file contains data for each of the 1,114 inpatient rehabilitation facilities used to estimate the final policy updates in the final inpatient rehabilitation prospective payment system regulation. The final methodology used to update the payment data is described in detail in the final rule.
• Case-Mix Groups, Relative Weights, and Average Length Of Stay - Values used in the final rule and the standard deviations from the average lengths of stay
• Tier Comorbidities – ICD-10-CM - This file contains the list of diagnoses (ICD-10-CM codes) that are used to determine placement in tiers for IRF discharges, effective October 1, 2021. It contains the ICD-10-CM codes, the abbreviated code labels, the appropriate tier, and any RICs for which the ICD-10-CM codes are excluded from the tiers. (Updated to reflect ICD-10-CM coding updates for October 1, 2021)
• Tier Comorbidities Changes - This file contains the list of diagnoses (ICD-10-CM codes) that have been added and/or removed from the tier comorbidities. (For ICD-10-CM coding updates, see https://www.cms.gov/medicare/icd-10/2022-icd-10-cm)
• Presumptive Compliance-3 (ICD-10-CM) - This file contains the list of diagnoses (ICD-10-CM codes) that are used for determining presumptive compliance with the IRF 60 percent rule, effective for discharges beginning on or after October 1, 2021. (Updated to reflect ICD-10-CM coding updates for October 1, 2021)
• Presumptive Compliance Changes - This file contains the list of diagnoses (ICD-10-CM codes) that have been added and/or removed from the list of diagnoses codes used for determining presumptive compliance with the IRF 60 percent rule. (For ICD-10-CM coding updates, see https://www.cms.gov/medicare/icd-10/2022-icd-10-cm).
• Impairment Group Codes That Meet Presumptive Compliance Criteria-3 (ICD-10-CM)  - This file contains the list of impairment group codes that are used for determining presumptive compliance with the IRF 60 percent rule, effective for discharges beginning on or after October 1, 2021. (There are no ICD-10-CM coding updates to this file for October 1, 2021).