CMS Proposes Changes to IRF, SNF and Inpatient Prospective Payment Systems

Members & Publications


May 1, 2018

Last week the Centers for Medicare & Medicaid Services (CMS) proposed changes to payment systems for IRF, SNF and Inpatient settings. These rules are open for public comment through late-June.

In the SNF setting, CMS proposes an aggregate $850 million increase in Medicare payments to SNFs in 2019. CMS has also proposed a new SNF case-mix model, the Patient Driven Payment Model (PDPM) which seeks to tie payment to patient’s conditions rather than volume of service provided.

CMS is also proposing a 1.35% increase to IRF payments for 2019. The IRF proposed rule details recommendations regarding decrease in documentation burden as well as an emphasis on meaningful quality measures.

Finally, the Inpatient rule proposes a $50 million increase in payments for 2019. During the comment period, CMS is seeking feedback on mechanisms for better achieving sharing of health care data between providers. Your Academy is in the process of reviewing the proposed rules and will submit comments on behalf of the membership this summer.   

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.