The Centers for Medicare & Medicaid Services (CMS) released final Fiscal Year 2027 Prospective Payment System (PPS) rules this week for Inpatient Rehabilitation Facilities (IRF) and Skilled Nursing Facilities (SNF). The policies and payment systems finalized in these rules will take effect on October 1, 2026.
FY 2027 IRF PPS Final Rule
CMS will be updating the IRF PPS payment rates by 2.3 percent for FY 2027.
This final rule also finalizes updates to the IRF coverage criteria, including:
- A new expedited 45-day IRF-Patient Assessment Instrument (PAI) data submission deadline, an update from the current requirement of 4.5 months.
- A new requirement that the Initial Interdisciplinary Team Meeting (IDT) must occur on or before 4 days, an update from the current requirement of 7 days.
- A new requirement that all therapies must be implemented no later than 36-hours from admission.
The final rule also summarizes input received on potential options to utilize the primary diagnosis and comorbidity score methodology under the SNF Patient-Driven Payment Model for the IRF PPS, as part of CMS’ process for considering potential future policies.
A fact sheet for this final rule with additional information can be found on the CMS website.
FY 2027 SNF PPS Final Rule
CMS will be updating the SNF PPS rates by 2.4 percent for FY 2027.
CMS will also be removing two measures related to COVID-19 vaccination coverage for personnel and patients/residents and will be considering input that it received through the comment process on the potential development of a new measure focused on advanced care planning for future years.
A fact sheet for this proposed rule with additional information can be found on the CMS website.
Your Academy submitted input to CMS on both the IRF and SNF proposed rules during the open comment period earlier this year. These comments primarily focused on proposed changes to the IRF coverage criteria and quality proposals, including registering serious concerns about the proposals to shorten the IRF-PAI submission deadline and to accelerate the timeline for holding IDT meetings.
AAPM&R is currently conducting in-depth review on both of these final rules and will provide additional updates to members on how these new policies might impact payment for PM&R services as appropriate.
If you have any questions regarding these final rules or payment policy for PM&R services in the IRF or SNF settings, please contact Academy staff at healthpolicy@aapmr.org.