Inpatient Rehabilitation · Estimator

IRF Payment Estimator

Estimate the FY 2026 IRF federal prospective payment from a CMG relative weight and area wage index, with rural, low-income, teaching, and high-cost-outlier adjustments. Enter the CMG weight from Table 2 of the final rule.

EstimatorBetaCMS-based
Data statusEstimator
Status
Estimator
Data year / effective
FY2026
Last reviewed
June 2026
Last updated
June 2026
Known exclusions
  • Wage index and facility CCRs vary by provider
  • Outlier, transfer, and short-stay adjustments are case-specific
  • Sequestration and MAC edits not applied
  • Validate against the IRF Pricer and your MAC

Estimate only — wage index, sequestration, and payer/MAC edits are not applied. Validate against CMS and your MAC before billing.

No PHIEstimator · BetaRuns entirely in your browser — no data leaves the page. Rates are CMS FY 2026 final-rule values; CMG weights come from CMS Table 2; this is an estimate — verify against the IRF Pricer and your MAC.

Inputs

CMG + Facility
Loads a sample case — every field stays editable.

Case

Facility adjustments

High-cost outlier (optional)

Outlier adds 80% of estimated cost (charges × CCR) above the payment plus the $10,062 threshold. Leave blank to skip.
Estimated IRF payment
$0.00
Enter a CMG relative weight
Estimate only. Excludes interrupted-stay, transfer, short-stay and death adjustments, sequestration, and any budget-neutrality wage factor. Verify against the IRF Pricer.
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