# 2025-06336: Medicare Tweaks Rehab Payments for 2026 2025-06336, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program, is a Federal Register proposed rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2025-04-30, effective 2025-10-01; deemed significant under Executive Order 12866; PRIA reads it as touching household money (as of 2026-10-14). - Canonical: https://policyrisk.com/federal-register/2025-06336 - As of: 2026-10-14 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Document number: 2025-06336 - Title: Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program - Type: Proposed Rule - Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services - Citation: 90 FR 18534 - Published: 2025-04-30 - Effective: 2025-10-01 - Comments close: not stated - Significant: yes (OIRA_API) - Touches household money: yes - Regulation identifier numbers: 0938-AV48 - Last updated: 2026-10-14 ## In one line Medicare Tweaks Rehab Payments for 2026 ## Summary Starting in fiscal year 2026, Medicare is updating how it pays inpatient rehab facilities, including changes to payment rates and how patient cases are grouped. The rule also continues to phase out extra payments for rural facilities and updates quality reporting rules. These changes affect rehab centers and could impact their funding starting October 1, 2025. ## Abstract This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2026. As required by statute, this proposed rule includes the proposed 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 proposed rule includes updates to the IRF Quality Reporting Program (QRP). ## Effects PRIA read - Medicare IRF payments updated for FY2026: benefit, medium. If you operate an inpatient rehabilitation facility (IRF), Medicare proposes updated payment rates for discharges on or after October 1, 2025 and through September 30, 2026. CMS projects a 3.4 percent market basket increase for FY2026 (based on IGI's Q4 2024 forecast), will apply a required product… - Case-mix weight changes shift payment distribution: mixed, low. CMS proposes updated case-mix group (CMG) relative weights and average length-of-stay (ALOS) values for FY2026 using FY2024 IRF claims and FY2023 cost report data. The CMG updates will be implemented in a budget-neutral manner using a budget neutrality factor of 0.9985, and CMS estimates 99.2 perce… - Rural payment adjustment phaseout continues: cost, low. CMS will continue the second year of a 3-year phaseout of the rural adjustment for IRFs transitioning from rural to urban status; this phaseout began in FY2025 and continues for FY2026 (affecting discharges on or after October 1, 2025). - IRF quality-reporting removals lower reporting costs: benefit, low. CMS proposes removing the COVID-19 Vaccination Coverage among Healthcare Personnel measure from the IRF Quality Reporting Program beginning with the FY2026 QRP, and removing the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measure plus four Social Determinants of Health (SDOH)… ## Related documents - [2026-20281](https://policyrisk.com/federal-register/2026-20281): Global Benchmark for Efficient Drug Pricing (GLOBE) Model, 2026-10-02 - [2026-20131](https://policyrisk.com/federal-register/2026-20131): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-10-01 - [2026-19959](https://policyrisk.com/federal-register/2026-19959): Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Prog…, 2026-09-30 - [2026-20067](https://policyrisk.com/federal-register/2026-20067): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction, 2026-09-30 - [2026-19946](https://policyrisk.com/federal-register/2026-19946): Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospectiv…, 2026-09-29 - [2026-15652](https://policyrisk.com/federal-register/2026-15652): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-08-03 ## Sources - [2025-06336 on federalregister.gov](https://www.federalregister.gov/documents/2025/04/30/2025-06336/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal) - [2025-06336 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06336.pdf) ## Related - [Previous: 2025-06317, Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospic…](https://policyrisk.com/federal-register/2025-06317) - [Next: 2025-06348, Medicare Program; Prospective Payment System and Consolidated Billing for Skill…](https://policyrisk.com/federal-register/2025-06348) - [All Federal Register documents](https://policyrisk.com/federal-register) Source: PRIA, https://policyrisk.com/federal-register/2025-06336 (as of 2026-10-14).