Complete Documents Library

Documents in Order of Date Posted or Modified

Click on a title to go to the document article, with download links if appropriate.

IRF Data Files FY2024 -- Last Updated: 10-17-2023
The associated file(s) (ZIP) are described below: IRF Wage Index Final Rule - These files contain the final urban and rural Core-Based Statistical Area FY 2024 IRF wage index tables. IRF Rate Setting Final Rule - This file contains...

IRF Data Files from CMS (2018 and prior) -- Last Updated: 10-17-2023
FY 2018 IRF PPS Final Rule Data Files (82 FR 36238) IRF Rate Setting Final Rule (82 FR 36238)  This file contains data for each of the 1,140 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient reh...

IRF Data Files FY2023 -- Last Updated: 10-17-2022
Download the data files described below via this link: associated file(s) (ZIP) IRF Wage Index - These files contain the final urban and rural Core-Based Statistical Area FY 2023 IRF wage index tables. IRF Rate Setting Rule - This file con...

IRF-PAI Manual -- Last Updated: 10-17-2022
FY 2024 Information IRF-PAI-Version-4.1-Effective-10-01-23-DRAFT (PDF) FY2023 Information CMS statement on the IRF PAI V4.0 unplanned discharges and IRF QRP compliance (PDF) CMS-Q&A-IRF-PAI-V4.0-unplanned-discharges-and-compliance...

IPPS and LTCH Final Rule FY2023, CAH Conditions of Participation -- Last Updated: 10-17-2022
Published August 10, 2022, this final rule will: revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; make changes relating to Medicare graduate medical education (...

IPPS Final Rule FY 2023 -- Last Updated: 08-05-2022
This final rule will: revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals; make changes relating to Medicare graduate medical education (GME) for teaching hospitals...

IRF Final Rule FY2023 -- Last Updated: 08-05-2022
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2023. As required by statute, this final rule includes the classification and weighting factors for the IRF prospective ...

ICD-10 -- Last Updated: 08-05-2022
2023 ICD-10-CM (CMS) 2023 Conversion Table (ZIP) 2023 Code Descriptions in Tabular Order (ZIP) 2023 Addendum (ZIP) 2023 Code Tables, Tabular and Index (ZIP) FY 2023 ICD-10-CM Coding Guidelines (PDF) POA Exempt Codes (ZIP...

COVID-19 New Codes, July 2022 -- Last Updated: 07-31-2022
COVID-19: Novavax Vaccine, Adjuvanted — New Codes The FDA authorized emergency use of the Novavax COVID-19 vaccine, Adjuvanted for the prevention of COVID-19 disease in patients 18 years and older. CMS issued 3 new CPT codes effective July 13...

Proposed Rule Conditions of Participation (CoPs) for Rural Emergency Hospitals (REH) and Critical Access Hospital CoP Updates -- Last Updated: 07-29-2022
This proposed rule would establish conditions of participation that Rural Emergency Hospitals (REH) must meet to participate in the Medicare and Medicaid programs. These requirements are intended to ensure that a high quality of care is furnished by ...

OPPS Proposed Rule FY 2023 -- Last Updated: 07-29-2022
CMS has issued a proposed rule to revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for Calendar Year (CY) 2023 based on CMS' continuing experience with these sy...

Long COVID Reporting -- Last Updated: 07-07-2022
Long COVID: Use ICD-10 Code U09.9 For a post COVID-19 condition, unspecified, like Long COVID, use code DX U09.9. Add other codes for conditions related to the COVID-19 infection, like R50.9 for fever. For a current COVID-19 infection, use code D...

June, 2022, New Codes for COVID-19: Pfizer-BioNTech Vaccines for Children as Young as 6 Months -- Last Updated: 07-04-2022
On June 17, 2022, the FDA amended the Pfizer-BioNTech COVID-19 vaccine emergency use authorization (PDF) to authorize use for all patients 6 months – 4 years old. Get important vial and dosing information. CMS issued new CPT codes effective June...

2023 Home Health Prospective Payment System Rate Update -- Last Updated: 07-04-2022
This proposed rule would set forth routine updates to the Medicare home health and home infusion therapy services payment rates for calendar year (CY) 2023 in accordance with existing statutory and regulatory requirements. This proposed rule discusse...

Rural Emergency Hospitals and Critical Access Hospital Conditions of Participation Updates -- Last Updated: 07-04-2022
CMS is releasing a new proposed rule protecting access to emergency care and additional outpatient services for people in rural communities. CMS is establishing the Conditions of Participation (CoPs) for Rural Emergency Hospitals (REHs). The proposed...

IPPS and LTCH Proposed Rule FY2023 -- Last Updated: 05-06-2022
On April 18, 2022 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1771-P) that provides updates to the fiscal year (FY) 2023 Long-Term Care Hospital Quality Reporting Program (LTCH QRP). This rule includes three Req...

March 2022 New COVID Codes -- Last Updated: 05-06-2022
On March 29, 2022, the FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF), including new packaging for vaccine boosters (blue cap). CMS issued new codes, effective March 29, 2022, for the vaccine booster and administration: ...

Physician Fee Schedule CY2022 -- Last Updated: 04-25-2022
CMS issued the CY 2022 Medicare Physician Fee Schedule (PFS) final rule that updates payment policies, payment rates, and other provisions for services. This is a summary of key provisions, effective on or after January 1, 2022: Revises telehe...

FY2018 IRF Final Rule -- Last Updated: 04-04-2022
The FY 2018 final policies are summarized below. Update to the payment rates under the IRF PPS. For FY 2018, CMS is finalizing an update to the IRF PPS payments to reflect a 1.0 percent increase factor, in accordance with section 1886(j...

IRF Grouper Update COVID-19 U07.1 added as Tier 3 -- Last Updated: 04-04-2022
Download the new grouper software from CMS, which includes U07.1 as a Tier 3. 

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