Inpatient Rehabilitation Facility Tier Comorbidity Updates
Inpatient Rehabilitation Facility Prospective Payment System
Inpatient Rehabilitation Facility Tier Comorbidity Updates
June 16, 2016
1
Purpose
To allow Inpatient Rehabilitation Facilities (IRFs) and other stakeholders to provide input and suggestions to CMS in the areas of concern/interest in updating the tier comorbidity portion of the
IRF payment prospective system (PPS)
2
Background
? Under the IRF PPS, Medicare patient cases are grouped into Rehabilitation Impairment Categories (RICs) based on the primary reason for intensive rehabilitation care.
? Cases are further grouped into case-mix groups (CMGs), which group similar cases according to age, motor, and cognitive scores.
? Within each CMG, cases are grouped into one of four tiers based on the presence of certain comorbidities (conditions that are secondary to the principal diagnosis or reason for the intensive rehabilitation care) that have been found to increase the cost of care.
? Each comorbidity tier (None, Tier 3, Tier 2, and Tier 1) adds a successively higher payment to the case.
3
Tier Comorbidity Update Project
? CMS is working with Acumen, LLC to analyze the tier comorbidities list and policies
? The tier comorbidities list was last updated in 2006 and 2007 ? CMS seeks early stakeholder input to ensure that we include in
our analysis stakeholder concerns and comments
4
The Tier Comorbidities List
? The FY 2017 Tier Comorbidities file contains the list of diagnoses (ICD-10-CM diagnosis codes) that are used to determine placement in tiers for IRF discharges, effective October 1, 2016. It contains the ICD-10-CM diagnosis codes, the abbreviated code labels, the appropriate tier, and any RICs for which the ICD-10-CM codes are excluded from the tiers.
? The file can be found at the following location:
5
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- rehabilitation center brochure norman regional
- hai national inpatient rehabilitation facilities centers for disease
- national directory of drug and alcohols treatment programs
- inpatient rehabilitation facility tier comorbidity updates
- treatment statistics national institute on drug abuse
- overview of substance use disorder care clinical guidelines medicaid
- behavioral health rehabilitation oklahoma
- title 450 department of mental health and substance abuse oklahoma
- diagnosis related groups drg inpatient services
- a guide to inpatient detoxification and residential rehabilitation
Related searches
- va tier 2 medication copay
- aarp medicare tier drug list
- va rx tier rate change
- va tier prescription copay
- cms inpatient rehabilitation guidelines
- tier 4 nys retirement benefits
- icd 10 inpatient rehabilitation coding
- inpatient facility coding guidelines
- nys pension system tier 4
- nys early retirement incentive 2020 tier 4
- nyc tier 4 pension calculator
- cpt for inpatient rehabilitation facility