Rule2025-23081
Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction
Primary source
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Published
December 17, 2025
Effective
December 17, 2025
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This document corrects typographical and technical errors in the final rule that appeared in the August 5, 2025, Federal Register entitled "Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program" (hereinafter referred to as the "FY 2026 IRF final rule"). The effective date was October 1, 2025.
Full Text
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<title>Federal Register, Volume 90 Issue 240 (Wednesday, December 17, 2025)</title>
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[Federal Register Volume 90, Number 240 (Wednesday, December 17, 2025)]
[Rules and Regulations]
[Pages 58509-58511]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-23081]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 412
[CMS-1829-CN]
RIN 0938-AV48
Medicare Program; Inpatient Rehabilitation Facility Prospective
Payment System for Federal Fiscal Year 2026 and Updates to the IRF
Quality Reporting Program; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule; correction.
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SUMMARY: This document corrects typographical and technical errors in
the final rule that appeared in the August 5, 2025, Federal Register
entitled ``Medicare Program; Inpatient Rehabilitation Facility
Prospective Payment System for Federal Fiscal Year 2026 and Updates to
the IRF Quality Reporting Program'' (hereinafter referred to as the
``FY 2026 IRF final rule''). The effective date was October 1, 2025.
DATES:
Effective date: This correction is effective December 17, 2025.
Applicability date: This correction is applicable to October 1,
2025.
FOR FURTHER INFORMATION CONTACT: Kimberly Schwartz, (410) 786-2571;
Patricia Taft (410) 786-4561.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2025-14780 of August 5, 2025, the FY 2026 IRF final rule
(90 FR 37678), there were typographical and technical errors that are
identified and corrected in this correcting document.
II. Summary of Errors
A. Summary of Errors in the Preamble
On pages 37678, 37681, 37698, 37699, 37718, 37719, 37720, 37721,
and 37724, due to a technical error in the calculation of the final FY
2026 IRF PPS payment rates, we inadvertently excluded a provider from
the FY 2026 payment rate analysis and impacts, which required
recalculation of the payment rates and impact analysis.
On page 37681, we included an incorrect section reference.
B. Summary of Errors and Corrections Posted on the CMS Website for the
IRF Wage Index
After the FY 2026 IRF PPS final rule was published, we identified
CMS Certification Numbers (CCNs) with more than 6 characters in the
provider-specific file indicating there are providers with multiple
records that have different provider characteristics. In the FY 2026
IRF PPS final rule, we inadvertently only included records with 6
character CCNs in our rate setting analysis resulting in one IRF
provider being excluded from the rate setting data. Therefore, in this
document we include that provider record with more than 6 characters
with the most recent effective date. The inclusion of the 236 claims
from this provider resulted in a change to the outlier threshold
(section VI. of the FY 2026 IRF PPS final rule) and changes to the
estimated payment impacts (section VII. of the FY 2026 IRF PPS final
rule).
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Section 1871(b)(1) of the Social Security Act (the Act) requires
the Secretary to provide for notice of a proposed rule in the Federal
Register and provide a period of not less than 60 days for public
comment. In addition, section 1871(e)(1)(B)(i) of the Act mandates a
30-day delay in effective date after issuance or publication of a rule.
Section 1871(b)(2)(C) of the Act provides an exception from the notice
and 60-day comment period and delay in effective date requirements of
the Act, under the good cause standard set forth in 5 U.S.C. 553(b)(B).
Section 1871(e)(1)(B)(ii) of the Act provides an exception from the
delay in effective date requirements of the Act as well. Section
553(b)(B) authorizes an agency to dispense with normal notice and
comment rulemaking procedures for good cause if the agency makes a
finding that the notice and comment process is impracticable,
unnecessary, or contrary to the public interest, and includes a
statement of the finding and the reasons for it in the rule. In
addition, section 1871(e)(1)(B)(ii) of the Act allows the agency to
avoid the 30-day delay in effective date where the waiver is necessary
to comply with statutory requirements or such delay is contrary to the
public interest and the agency includes in the rule a statement of the
finding and the reasons for it. In our view, this correcting document
does not constitute a rulemaking that would be subject to these
requirements.
This document merely corrects typographical and technical errors in
the FY 2026 IRF final rule. The corrections contained in this document
are consistent with, and do not make substantive changes to, the
policies and payment methodologies that were proposed, subject to
notice and
[[Page 58510]]
comment procedures, and adopted in the FY 2026 IRF final rule. As a
result, the corrections made through this correcting document are
intended to resolve inadvertent errors so that the rule accurately
reflects the policies adopted in the final rule. Even if this were a
rulemaking to which the notice and comment and delayed effective date
requirements applied, we find that there is good cause to waive such
requirements. Undertaking further notice and comment procedures to
incorporate the corrections in this document into the FY 2026 IRF final
rule or delaying the effective date of the corrections would be
contrary to the public interest because it is in the public interest to
ensure that the rule accurately reflects our policies as of the date
they take effect. Further, such procedures would be unnecessary because
we are not making any substantive revisions to the final rule, but
rather, we are simply correcting the Federal Register document to
reflect the policies that we previously proposed, received public
comment on, and subsequently finalized in the final rule. For these
reasons, we believe there is good cause to waive the requirements for
notice and comment and delay in effective date.
IV. Correction of Errors
In FR Doc. 2025-14780 of August 5, 2025, make the following
corrections:
1. On page 37678, Table 1 titled ``Cost and Transfers'', second
row, second column, the figure that reads ``$340 million'' is corrected
to read ``$335 million''.
2. On page 37681, second column,
a. Second bulleted paragraph, the section reference that reads
``VI'' is corrected to read ``VII''.
b. Third bulleted paragraph, the section reference that reads
``VI'' is corrected to read ``VII''.
3. On page 37698, under Table 7, third column, last paragraph, line
9, the figure that reads ``$10,062'' is corrected to read ``$10,141''.
4. On page 37699, third column, first full paragraph,
a. Line 5, the figure that reads ``2.4'' is corrected to read
``2.5''.
b. Line 8, the figure that reads ``$10,062'' is corrected to read
``$10,141''.
c. Line 17, the figure that reads ``$10,062'' is corrected to read
``$10,141''.
5. On page 37718,
a. Second column, first full paragraph, line 10, the figure that
reads ``$340 million'' is corrected to read ``$335 million''.
b. Third column,
(1) First partial paragraph, line 5, the figure that reads
``1,169'' is corrected to read ``1,170''.
(2) First full paragraph, line 18, the figure that reads ``1,169''
is corrected to read ``1,170''.
6. On page 37719,
a. First column, first paragraph under the heading ``1. Impact on
IRFs'', line 4, the figure that reads ``$340 million'' is corrected to
read ``$335 million''.
b. Second column,
(1) First full paragraph, line 13, the figure that reads ``$340
million'' is corrected to read ``$335 million''.
(2) Second full paragraph, line 14, the figure that reads ``$340
million'' is corrected to read ``$335 million''.
c. Third column, under the heading ``2. Description of Table 14'',
(1) Line 2, the figure that reads ``1,169'' is corrected to read
``1,170''.
(2) Line 15, the figure that reads ``1,024'' is corrected to read
``1,025''.
(3) Line 17, the figure that reads ``646'' is corrected to read
``647''.
(4) Line 29, the figure that reads ``465'' is corrected to read
``466''.
7. On pages 37720 and 37721, Table 14 titled ``IRF Impact for FY
2026 (Columns 4 through 7 in percentages)'', is corrected to read as
follows:
Table 14--IRF Impact for FY 2026
[Columns 4 through 7 in percentages]
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FY 2026 CBSA & Total
Facility classification Number of Number of Outlier FY 2026 wage CMG percent
IRFs cases index weights change \1\
(1) (2) (3) (4) (5) (6) (7)
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Total............................... 1,170 447,256 0.6 0.0 0.0 3.2
Urban unit.......................... 647 144,310 1.1 -0.2 0.0 3.6
Rural unit.......................... 131 18,147 0.9 -0.1 0.1 3.5
Urban hospital...................... 378 277,797 0.2 0.1 0.0 2.9
Rural hospital...................... 14 7,002 0.0 0.4 0.0 3.0
Urban For-Profit.................... 482 276,263 0.3 0.1 0.0 2.9
Rural For-Profit.................... 39 10,714 0.3 0.3 0.0 3.2
Urban Non-Profit.................... 466 127,753 1.0 -0.1 0.0 3.6
Rural Non-Profit.................... 87 12,573 0.9 -0.1 0.1 3.5
Urban Government.................... 77 18,091 1.2 -0.1 0.1 3.8
Rural Government.................... 19 1,862 0.6 -0.6 0.1 2.8
Urban............................... 1,025 422,107 0.6 0.0 0.0 3.2
Rural............................... 145 25,149 0.6 0.1 0.1 3.4
Urban by region:
Urban New England............... 30 15,484 0.3 1.6 0.1 4.7
Urban Middle Atlantic........... 113 42,826 0.7 0.3 0.0 3.6
Urban South Atlantic............ 190 100,441 0.5 0.5 0.0 3.6
Urban East North Central........ 165 50,402 0.6 0.3 0.0 3.5
Urban East South Central........ 56 29,048 0.2 0.7 0.0 3.5
Urban West North Central........ 80 25,558 0.6 0.2 0.0 3.5
Urban West South Central........ 210 95,608 0.3 -0.7 0.0 2.1
Urban Mountain.................. 81 35,924 0.4 -0.5 0.0 2.4
Urban Pacific................... 100 26,816 1.5 -1.0 0.0 3.1
Rural by region:
Rural New England............... 5 1,104 0.9 1.0 0.1 4.6
Rural Middle Atlantic........... 11 1,408 0.4 -1.4 0.1 1.6
Rural South Atlantic............ 17 6,383 0.2 0.1 0.0 2.9
Rural East North Central........ 23 3,022 1.2 0.3 0.0 4.1
Rural East South Central........ 19 3,284 0.5 -1.2 0.1 1.9
[[Page 58511]]
Rural West North Central........ 19 2,310 1.1 0.2 0.1 4.0
Rural West South Central........ 44 7,042 0.5 0.4 0.1 3.6
Rural Mountain.................. 5 322 0.9 3.8 0.1 7.5
Rural Pacific................... 2 274 3.0 0.4 0.3 6.3
Teaching status:
Non-teaching.................... 1,064 398,566 0.5 0.0 0.0 3.1
Resident to ADC less than 10%... 59 33,458 0.6 0.0 0.0 3.2
Resident to ADC 10%-19%......... 34 12,761 1.5 -0.3 0.0 3.8
Resident to ADC greater than 19% 13 2,471 0.9 0.2 0.1 3.8
Disproportionate share patient
percentage (DSH PP):
DSH PP = 0%..................... 52 12,309 0.6 -0.6 0.0 2.7
DSH PP <5%...................... 194 98,674 0.4 0.3 0.0 3.3
DSH PP 5%-10%................... 252 110,048 0.4 -0.1 0.0 3.0
DSH PP 10%-20%.................. 404 150,145 0.6 0.0 0.0 3.2
DSH PP greater than 20%......... 268 76,080 0.9 -0.2 0.0 3.4
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\1\ This column includes the impact of the updates in columns (4), (5), and (6) above, and of the IRF market
basket update for FY 2026 of 3.3 percent, reduced by 0.7 percentage point for the productivity adjustment as
required by section 1886(j)(3)(C)(ii)(I) of the Act. Note, the products of these impacts may be different from
the percentage changes shown here due to rounding effects.
8. On page 37721, under the heading ``3. Impact of the Update to
the Outlier Threshold Amount'', first column, second paragraph,
a. Line 6, the figure that reads ``2.4'' is corrected to read
``2.5''.
b. Line 10, the figure that reads ``$10,062'' is corrected to read
``$10,141''.
c. Line 19, the figure that reads ``2.4'' is corrected to read
``2.5''.
9. On page 37724,
a. Table 19 titled ``Accounting Statement--Classification of
Estimated Expenditure'', third column, the figure that reads ``$340
million'' is corrected to read ``$335 million''.
b. Under the heading, ``G. Conclusion'', first column, third
paragraph, line 5, the figure that reads ``7.6'' is corrected to read
``7.5''.
Liesl I. Fowler,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2025-23081 Filed 12-16-25; 8:45 am]
BILLING CODE 4120-01-P
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</html>Indexed from Federal Register on December 17, 2025.
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