Crosswalk

Crosswalk for Changes to the Inpatient Rehabilitation Facility

Patient Assessment Instrument (IRF-PAI) Version 4.3 to 4.4

(CMS-10036; OMB No. 0938-0842)

Section # on Approved IRF-PAI v4.3 (Oct 1, 2026)	Type of Change	Rationale for Change
IDENTIFICATION INFORMATION – ADMISSION	Remove 8. Gender.	This item is being updated to A0810 to be consistent with EO 14168 Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.
SECTION A: ADMINISTRATIVE INFORMATION – ADMISSION	Add A0810. Sex	Item updated to be consistent with EO 14168 Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.
SECTION A: ADMINISTRATIVE INFORMATION– ADMISSION	Add A1255. Transportation (from NACHC©) with citation.	Adding this item (replacing R0340. Transportation) to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf)
SECTION R: HEALTH-RELATED SOCIAL NEEDS– ADMISSION	Remove new section of IRF-PAI	Given the changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf), CMS will remove this section of the IRF-PAI.
SECTION R: HEALTH-RELATED SOCIAL NEEDS– ADMISSION	Remove R0310. Living Situation with citation.	Necessary to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf).
SECTION R: HEALTH-RELATED SOCIAL NEEDS– ADMISSION	Remove R0320.A and R0320B. Food with citation.	Necessary to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf)
SECTION R: HEALTH-RELATED SOCIAL NEEDS– ADMISSION	Remove R0330. Utilities with citation.	Necessary to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf)
SECTION R: HEALTH-RELATED SOCIAL NEEDS– ADMISSION	Remove R0340. Transportation with citation.	Necessary to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf)
SECTION O: SPECIAL TREATMENTS, PROCEDURES, AND PROGRAMS – DISCHARGE	Remove O0350. Patient’s COVID-19 vaccination is up to date.	Necessary to implement changes proposed in the FY 2026 IRF PPS proposed rule (available https://public-inspection.federalregister.gov/2025-06336.pdf)

Crosswalk for Changes to the IRF-PAI Version 4.3 to 4.4 2 of 2