Table 3.

Reasonable and Necessary Criteria for IRF Admission⁶

Reasonable and Necessary Criteria Specify a preadmission assessment that a rehabilitation physician reviewed and approved prior to IRF admission Require a post-admission physician evaluation to verify that the patient’s preadmission assessment information remains unchanged or to document any changes Specify requirements for an individualized overall plan of care for each patient Emphasize the interdisciplinary approach to care provided in IRFs and require interdisciplinary team meetings at least once Clarify the requirements for admission to an IRF by specifying that a patient must: Require the active and ongoing therapeutic intervention of multiple therapy disciplines Generally require an intensive rehabilitation therapy program uniquely provided in IRFs Be sufficiently medically stable to benefit from IRF services Require close medical supervision by a physician for managing medical conditions to support participation in an intensive rehabilitation therapy program Require an intensive and coordinated interdisciplinary approach to care

IRF=Acute Inpatient Rehabilitation Facility