IRF Annual Update: PPS Pricer Changes for FY 2020 - Revised

MLN Matters Number: MM11345
Related CR Release Date: August 2, 2019
Related CR Transmittal Number: R4353CP
Related Change Request (CR) Number: 11345
Effective Date: October 1, 2019
Implementation Date: October 7, 2019

Note: CMS revised this article on August 16, 2019, to reflect a revised CR11345 issued on August 15. CMS revised the CR to replace the Health Insurance Prospective Payment System (HIPPS) Case Mix Group (CMG) Codes spreadsheet with a corrected version. In this article, CMS revised the CR release date, transmittal number and the web address of the CR. All other information remains the same.

CR 11345 notifies MACs that a new Inpatient Rehabilitation Facility (IRF) Pricer software package will be released prior to October 1, 2019, which will contain the updated rates that are effective for claims with discharges that fall within October 1, 2019, through September 30, 2020. MACs will install and pay IRF claims with the FY 2020 IRF Prospective Payment System (PPS) Pricer for discharges on or after October 1, 2019. Make sure your billing staffs are aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11345.

Last Updated Aug 19, 2019