CMS-1804-F

This rule (CMS-1804-F) is on public display at the Office of the Federal Register and will publish on August 6, 2024. 

The associated file(s) (ZIP) are described below and select files were replaced on August 6, 2024 to align formatting with prior years:

• IRF Wage Index Final Rule - These files contain the final urban and rural Core-Based Statistical Area FY 2025 IRF wage index tables.
• IRF Rate Setting Final Rule - This file contains data for each of the 1,160 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient rehabilitation prospective payment system regulation. The 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, 2024. 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, 2024)
• Tier Comorbidities Changes - This file contains the list of diagnoses (ICD-10-CM codes) that have been added or removed from the tier comorbidities. This file also lists code label changes to diagnoses. (For ICD-10-CM coding updates, see  2025 files)
• 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, 2023. (Updated to reflect ICD-10-CM coding updates for October 1, 2024)
• 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  2025 files).
• 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, 2024. (There are no ICD-10-CM coding updates to this file for October 1, 2024).