Medicare Payment Policy

FIguRe FIGURE
10–1
9-1
Note: IRF (inpatient rehabilitation facility).
Source: MedPAC analysis of 2011 Provider of Services files from CMS.
Source: Note and Source in InDesign.
Background
After an illness, injury, or surgery, some patients
enter intensive rehabilitation programs at an inpatient
rehabilitation facility (IRF) and receive services such
as physical and occupational therapy and rehabilitation
nursing in a coordinated, multidisciplinary manner. For
these services to qualify for Medicare coverage, the care
for IRF patients must be supervised by a rehabilitation
physician, use an interdisciplinary approach to care, and
geographic Geographic distribution of of IRFs, 2011 2009
Number of IRFs by county
10 or more
6 to 9
4 to 5
2 to 3
1
address a documented clinical need for therapy in at least
two disciplines. IRFs may be specialized units within an
acute care hospital or specialized freestanding hospital,
which tend to be larger. Approximately 80 percent of
facilities are hospital-based units and 20 percent are
freestanding. However, hospital-based units accounted for
only 55 percent of Medicare discharges to IRFs in 2011.
In 2011, there were 1,165 IRFs in the United States,
representing about 35,250 beds, with at least one in
every state and the District of Columbia (Figure 10-1). In
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