Inpatient Rehabilitation Facility - Patient Assessment Instrument

IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program (CMS-10036)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0842 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10036 Inpatient Rehabilitation Facility - Patient Assessment Instrument Form and Instruction
CMS-10036 IRF- PAI version 4.2 IRF-PAI-Version-4.2-Effective-10-01-24-v3_clean.docx Form and Instruction
Final-Specifications-for-IRF-QRP-Quality-Measures-and-SPADEs.pdf Instruction
CMS-10036 IRF- PAI version 4.3 IRF-PAI-Version-4.3-Effective-10-01-26-v6.pdf Form and Instruction
Crosswalk_IRF-PAI 4.2 to 4.3_v2.docx Crosswalk IC Document

Information Collection (IC) Details