Available For: Part A - California Only

This demonstration applies to Inpatient Rehab Facilities (IRF) that provide rehabilitation services, are enrolled in the Medicare Fee-for-Service (FFS) program, submit claims to Jurisdiction E and render services in the state of California.

Inpatient Rehab Facilities (IRF) are able to choose how their claims are reviewed, either before or after payment, based on their compliance history.

To learn more about the RCD, view the Review Choice Demonstration (RCD) page.

To make a selection, complete the following steps once you are logged into your NMP account. If you do not have an NMP account, use the “Start Registration” button on the NMP login page and view the Registration Guide for step-by-step instructions.

IRF RCD Review Choice Selection

• Select Prior Authorization tab from the main menu and then choose the Review Choice Demonstration (RCD) tab
• Choose TIN/NPI/PTAN and Program, if needed, under Provider/Supplier Details (IRFs choice selection is made at the PTAN level).
• Choose the “IRF RCD Review Choice Demonstration Selection” button

Note: If “IRF RCD Review Choice Demonstration Selection” button is not green, this indicates that the selection period is not open.

Make a selection:

• Pre-claim Review (PCR)
• Postpayment Review

Choose “Submit Selection Choice” button. Once selected, a confirmation page will display with the NPI, PTAN, TIN and IRF RCD Selection choice.

Cycle Results Inquiry

View the results from each IRF RCD cycle for your facilities PTAN.

• Choose TIN/NPI/PTAN and Program, if needed, under Provider/Supplier Details
• Choose “Cycle Results Inquiry”

Your facilities cycle results will display. Ensure the information on the results screen is reviewed to help understand the results.