5 Aug 2025

💵Medicare Updates IRF Payment Rates for FY 2026

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program

Summary

This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2026. As required by statute, this final rule includes the classification and weighting factors for the IRF prospective payment system's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2026. It also continues the second year of the 3-year phaseout of the rural adjustment, which began in FY 2025. Additionally, the final rule includes updates to the IRF Quality Reporting Program.

Agencies

  • Health and Human Services Department
  • Centers for Medicare & Medicaid Services

Business Impact ?

$$$ - High

This regulatory update affects payment rates and methodologies for inpatient rehabilitation facilities (IRFs), which will directly impact financial planning and reimbursement strategies. The $340 million increase in payments for FY 2026 (as detailed in the text) presents significant financial implications for IRFs and healthcare providers.

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