CMS Data Files for Inpatient Rehabilitation Facilities

On September 20, 2018, in Documents, by AQ-IQ LLC

FY2020 Final Rule

Data Files Download for FY2020 (zip) includes:

  • IRF Wage Index Final Rule – These files contain the proposed urban and rural Core-Based Statistical Area FY 2020 IRF wage index tables.
  • IRF Rate Setting Final Rule – This file contains data for each of the 1,122 inpatient rehabilitation facilities used to estimate the policy updates in the 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
  • The IRF Technical Report “Analyses to Inform the Use of Standardized Patient Assessment Data Elements in the Inpatient Rehabilitation Facility Prospective Payment System” (March 2019) is available on the IRF Research web page.
    • Tier Comorbidities – ICD-10-CM (Updated 8-01-2019)
      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, 2019. 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, 2019)
    • 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/Coding/ICD10/2019-ICD-10-CM.html)
    • Presumptive Compliance-3 (ICD-10-CM) – Updated 8-01-2019
      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, 2019. (Updated to reflect ICD-10-CM coding updates for October 1, 2019)
    • 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/Coding/ICD10/2019-ICD-10-CM.html).
    • 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, 2019. (There are no ICD-10-CM coding updates to this file for October 1, 2019)

FY 2019 IRF PPS Final Rule Data Files (83 FR 38514)

IRF Rate Setting Final Rule (83 FR 38514)  This file contains data for each of the 1,126 inpatient rehabilitation facilities used to estimate the policy updates in the 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 (83 FR 38514) and the standard deviations from the average lengths of stay.

Provider Specific Impact Analysis (83 FR 38514) This file contains the unadjusted estimated payment impacts for providers due to the case-mix classification revisions that will be effective in FY 2020, as described in the FY 19 IRF PPS Final Rule.  

IRF Wage Index Final Rule (83 FR 38514) These files contain the proposed urban and rural Core-Based Statistical Area FY 2019 IRF wage index tables.

Tier Comorbidities – ICD-10-CM – Updated 8-01-2018 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, 2018. 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, 2018)

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/Coding/ICD10/2019-ICD-10-CM.html)

Presumptive Compliance-3 (ICD-10-CM) – Updated 8-01-2018

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, 2018. (Updated to reflect ICD-10-CM coding updates for October 1, 2018)

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/Coding/ICD10/2019-ICD-10-CM.html).

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, 2018. (There are no ICD-10-CM coding updates to this file for October 1, 2018)

FY 2019 IRF PPS Proposed Rule Data Files (83 FR 20972)

IRF Wage Index Proposed Rule (83 FR 20972) These files contain the proposed urban and rural Core-Based Statistical Area FY 2019 IRF wage index tables.

IRF Rate Setting Proposed Rule (83 FR 20972)  This file contains data for each of the 1,124 inpatient rehabilitation facilities used to estimate the proposed policy updates in the proposed inpatient rehabilitation prospective payment system regulation. The proposed methodology used to update the payment data is described in detail in the proposed rule.

Case-Mix Groups, Relative Weights, and Average Length Of Stay Values used in the proposed rule (83 FR 20972) and the standard deviations from the average lengths of stay.

Comments are closed.