# 2026-06642: Medicare Tweaks Rehab Payments and Therapy Rules for 2027

2026-06642, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 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 2026-04-06, effective To be assured consideration, comments must be received at one of the addresses provided below by June 1, 2026.; deemed significant under Executive Order 12866 (as of 2026-11-04).

- Canonical: https://policyrisk.com/federal-register/2026-06642
- As of: 2026-11-04
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Document number: 2026-06642
- Title: Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program
- Type: Proposed Rule
- Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services
- Citation: 91 FR 17195
- Published: 2026-04-06
- Effective: To be assured consideration, comments must be received at one of the addresses provided below by June 1, 2026.
- Comments close: not stated
- Significant: yes (OIRA_API)
- Touches household money: no
- Regulation identifier numbers: 0938-AV76
- Last updated: 2026-11-04

## In one line

Medicare Tweaks Rehab Payments and Therapy Rules for 2027

## Summary

Starting in fiscal year 2027, Medicare is updating how it pays inpatient rehab facilities, including new rules to start therapy within 36 hours of admission and better tracking of patient progress. Rural payment boosts will continue to phase out, and quality reporting gets a refresh. These changes affect rehab centers and patients, with public comments open until June 1, 2026, so everyone can weigh in before the new rules kick in.

## Abstract

This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2027. As required by statute, this proposed 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 2027. It also continues the third year of the 3-year phaseout of the rural adjustment, which began in FY 2025. This proposed rule includes a solicitation for public comments on alternative data sources for the IRF PPS wage index; proposes to require all therapy treatments or therapy evaluations to begin within 36-hours from midnight on the day of admission; proposes to require a patient's current functional status be documented on the preadmission screening; proposes requirements for the initial Interdisciplinary Team meeting; and includes a request for information on potential future IRF PPS payment reform. Additionally, the proposed rule includes updates to the IRF Quality Reporting Program. Furthermore, the proposed rule includes changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program.

## Effects PRIA read

No economic effects identified for this document.

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## Sources
- [2026-06642 on federalregister.gov](https://www.federalregister.gov/documents/2026/04/06/2026-06642/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal)
- [2026-06642 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-04-06/pdf/2026-06642.pdf)

## Related
- [Previous: 2026-06633, Reducing Bureaucracy and Burden in Family Violence and Prevention Services](https://policyrisk.com/federal-register/2026-06633)
- [Next: 2026-06646, Reducing Bureaucracy and Burden for Children, Youth, and Family Programs](https://policyrisk.com/federal-register/2026-06646)
- [All Federal Register documents](https://policyrisk.com/federal-register)

Source: PRIA, https://policyrisk.com/federal-register/2026-06642 (as of 2026-11-04).