2025-14780RuleSignificantWallet

Medicare Updates Inpatient Rehab Payments for 2026

Published Date: 8/5/2025

Rule

Summary

Starting in FY 2026, inpatient rehab facilities will see updated payment rates and changes to how patient cases are grouped and valued. The rural payment boost is being phased out for the second year, which might affect some smaller or rural facilities' funding. Plus, quality reporting rules are getting a refresh to keep care top-notch and transparent.

Analyzed Economic Effects

4 provisions identified: 1 benefits, 1 costs, 2 mixed.

FY2026 IRF Payment Rate Update

The rule updates the inpatient rehabilitation facility (IRF) prospective payment rates for Federal fiscal year (FY) 2026. It includes the classification and weighting factors used to compute those FY 2026 payment rates.

Case-Mix Grouping & Weight Changes

The rule includes the classification and weighting factors for the IRF prospective payment system's case-mix groups that apply for FY 2026. It also describes the methods and data used to compute those case-mix group values.

Rural Adjustment Phaseout Continues

The rule continues the second year of a 3-year phaseout of the rural adjustment that began in FY 2025. This continues a scheduled reduction in the rural payment adjustment for IRFs.

IRF Quality Reporting Updates

The rule updates the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. These updates affect how IRFs report quality measures and are intended to maintain transparency and quality monitoring.

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Key Dates

Published Date
8/5/2025

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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