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Policy Compendium

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MRC-037: Medicare Diagnostic Categories Payment Schedule

 
Medicare Diagnostic Categories Payment Schedule: The Wisconsin Medical Society supports the elimination of the Medicare “60 percent rule,” which states that 60 percent of patients over the course of a year admitted to an inpatient rehabilitation facility must have one of 13 conditions stated in 42 Code of Federal Regulations (CFR) 412.29(b)(2) in order for the facility to qualify for payment under the inpatient rehabilitation facility prospective payment system such that admission to inpatient rehab facilities can be based on the functional needs of the patients and their ability to improve in a reasonable amount of time. (HOD, 0418)