{"abstract":"In this final rule, we are establishing the prospective payment rates for inpatient hospital services furnished under Medicare by inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2004, as required under section 1886(j)(3)(C) of the Social Security Act (the Act). As required by law and regulations, we are specifying the classification and weighting factors for the IRF case- mix groups and providing a description of the methodology and data used in computing the prospective payment rates for FY 2004. These rates are applicable to discharges occurring on or after October 1, 2003 and before October 1, 2004. In addition, we are revising and clarifying policies governing the payment for inpatient hospital services furnished by IRFs under the IRF PPS.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2003/08/01/03-19540.html","cfr_references":[{"chapter":null,"citation_url":null,"part":412,"title":42}],"citation":"68 FR 45674","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective: October 1, 2003. The updated IRF prospective payment rates are applicable for discharges on or after October 1, 2003 and on or before September 30, 2004 (FY 2004).","disposition_notes":null,"docket_ids":["CMS-1474-F"],"dockets":[],"document_number":"03-19540","effective_on":"2003-10-01","end_page":45728,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2003/08/01/03-19540.xml","html_url":"https://www.federalregister.gov/documents/2003/08/01/03-19540/medicare-program-changes-to-the-inpatient-rehabilitation-facility-prospective-payment-system-and","images":{"ER01AU03.005":{"large":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_large.png","medium":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_original_size.png"},"ER01AU03.006":{"large":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_large.png","medium":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_original_size.png"},"ER01AU03.007":{"large":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_large.png","medium":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_original_size.png"},"ER01AU03.008":{"large":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_large.png","medium":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_original_size.png"},"ER01AU03.001":{"large":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_large.png","medium":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_original_size.png"},"ER01AU03.002":{"large":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_large.png","medium":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_original_size.png"},"ER01AU03.003":{"large":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_large.png","medium":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_original_size.png"},"ER01AU03.004":{"large":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_large.png","medium":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_original_size.png"},"ER01AU03.010":{"large":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_large.png","medium":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_original_size.png"},"ER01AU03.000":{"large":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_large.png","medium":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_original_size.png"},"ER01AU03.009":{"large":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_large.png","medium":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_medium.png","original_size":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_original_size.png"}},"images_metadata":{"ER01AU03.005":{"large":{"identifier":"ER01AU03.005","content_type":"image/png","size":114406,"width":822,"sha":"e4cc9f8b1f067282fb17082ed244f2f8","url":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_large.png","height":1077},"medium":{"identifier":"ER01AU03.005","content_type":"image/png","size":61982,"width":515,"sha":"426ae084b19278eb0bd44437ae8b7272","url":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_medium.png","height":674},"original_size":{"identifier":"ER01AU03.005","content_type":"image/png","size":369700,"width":3890,"sha":"63921b95800362f069b4cfce79245ca8","url":"https://img.federalregister.gov/ER01AU03.005/ER01AU03.005_original_size.png","height":5094}},"ER01AU03.006":{"large":{"identifier":"ER01AU03.006","content_type":"image/png","size":120941,"width":823,"sha":"b7babd0cd540258ca57240c2655322b3","url":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_large.png","height":1105},"medium":{"identifier":"ER01AU03.006","content_type":"image/png","size":62521,"width":514,"sha":"0f571bf1ccb75e3511512f7758cf6d88","url":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_medium.png","height":691},"original_size":{"identifier":"ER01AU03.006","content_type":"image/png","size":374502,"width":3890,"sha":"d4156237955cfdaa7729902cdbe9f84f","url":"https://img.federalregister.gov/ER01AU03.006/ER01AU03.006_original_size.png","height":5226}},"ER01AU03.007":{"large":{"identifier":"ER01AU03.007","content_type":"image/png","size":114376,"width":822,"sha":"5e25cd177e7419683930ea7375b66495","url":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_large.png","height":1101},"medium":{"identifier":"ER01AU03.007","content_type":"image/png","size":57833,"width":511,"sha":"ff2f479f5417ebf264cce91e07f86a50","url":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_medium.png","height":685},"original_size":{"identifier":"ER01AU03.007","content_type":"image/png","size":367085,"width":3866,"sha":"3c545406ed5ff5599de6d16c26d0f7c9","url":"https://img.federalregister.gov/ER01AU03.007/ER01AU03.007_original_size.png","height":5178}},"ER01AU03.008":{"large":{"identifier":"ER01AU03.008","content_type":"image/png","size":119079,"width":823,"sha":"6776fc31210f4c9a1fd37ca8b3628bdb","url":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_large.png","height":1107},"medium":{"identifier":"ER01AU03.008","content_type":"image/png","size":61904,"width":513,"sha":"576a931a3ed7b1032948f6734a756305","url":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_medium.png","height":690},"original_size":{"identifier":"ER01AU03.008","content_type":"image/png","size":367652,"width":3878,"sha":"cc2d532659c9c39395add4c02d776c3e","url":"https://img.federalregister.gov/ER01AU03.008/ER01AU03.008_original_size.png","height":5214}},"ER01AU03.001":{"large":{"identifier":"ER01AU03.001","content_type":"image/png","size":161295,"width":822,"sha":"c53c9435ad93441c95beb26b88062797","url":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_large.png","height":1164},"medium":{"identifier":"ER01AU03.001","content_type":"image/png","size":57823,"width":460,"sha":"f03707245d0814ba06c234230a5338d8","url":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_medium.png","height":651},"original_size":{"identifier":"ER01AU03.001","content_type":"image/png","size":422036,"width":3472,"sha":"90099fac72aee68457ca5367f86c2434","url":"https://img.federalregister.gov/ER01AU03.001/ER01AU03.001_original_size.png","height":4914}},"ER01AU03.002":{"large":{"identifier":"ER01AU03.002","content_type":"image/png","size":152306,"width":823,"sha":"3b4671cb8a132e3a78655e3d3a599ffe","url":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_large.png","height":1151},"medium":{"identifier":"ER01AU03.002","content_type":"image/png","size":57435,"width":476,"sha":"7bbee05e9d38c8be4411ceb3701d7340","url":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_medium.png","height":665},"original_size":{"identifier":"ER01AU03.002","content_type":"image/png","size":419874,"width":3592,"sha":"be2cec9ce5cf5538295dc91d953323eb","url":"https://img.federalregister.gov/ER01AU03.002/ER01AU03.002_original_size.png","height":5022}},"ER01AU03.003":{"large":{"identifier":"ER01AU03.003","content_type":"image/png","size":100066,"width":823,"sha":"d07de26d52d5a286138781c33e45ebe2","url":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_large.png","height":1174},"medium":{"identifier":"ER01AU03.003","content_type":"image/png","size":52357,"width":515,"sha":"880d175d15f029fad519a74a6bf6059a","url":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_medium.png","height":734},"original_size":{"identifier":"ER01AU03.003","content_type":"image/png","size":312059,"width":3891,"sha":"f04e75e2af61667c06b1f13984745f6b","url":"https://img.federalregister.gov/ER01AU03.003/ER01AU03.003_original_size.png","height":5550}},"ER01AU03.004":{"large":{"identifier":"ER01AU03.004","content_type":"image/png","size":120273,"width":823,"sha":"76cc50b52ac5c7b067e22a1d97f1fd80","url":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_large.png","height":1103},"medium":{"identifier":"ER01AU03.004","content_type":"image/png","size":61033,"width":510,"sha":"0e55b656db9b810f119ec85f8cd3d453","url":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_medium.png","height":684},"original_size":{"identifier":"ER01AU03.004","content_type":"image/png","size":384547,"width":3854,"sha":"fe6002c871c01c0ac5dc483277921de0","url":"https://img.federalregister.gov/ER01AU03.004/ER01AU03.004_original_size.png","height":5166}},"ER01AU03.010":{"large":{"identifier":"ER01AU03.010","content_type":"image/png","size":146993,"width":823,"sha":"4764b7b6688573af0f2e78602a41ab90","url":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_large.png","height":1238},"medium":{"identifier":"ER01AU03.010","content_type":"image/png","size":46214,"width":401,"sha":"9a59632a9905ecf31240ff4b4ac99684","url":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_medium.png","height":603},"original_size":{"identifier":"ER01AU03.010","content_type":"image/png","size":305248,"width":3028,"sha":"cbc4c63888582d0cde859e8c9e9e1c7d","url":"https://img.federalregister.gov/ER01AU03.010/ER01AU03.010_original_size.png","height":4555}},"ER01AU03.000":{"large":{"identifier":"ER01AU03.000","content_type":"image/png","size":8525,"width":683,"sha":"a659bd092f7a39d55bcbf1e514f5559b","url":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_large.png","height":131},"medium":{"identifier":"ER01AU03.000","content_type":"image/png","size":2869,"width":322,"sha":"839e79a16417ebc44dbc34bb0b9f28a5","url":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_medium.png","height":62},"original_size":{"identifier":"ER01AU03.000","content_type":"image/png","size":1992,"width":292,"sha":"d69305183428dbd54e4c53e85ecf298f","url":"https://img.federalregister.gov/ER01AU03.000/ER01AU03.000_original_size.png","height":56}},"ER01AU03.009":{"large":{"identifier":"ER01AU03.009","content_type":"image/png","size":168832,"width":822,"sha":"844aa4aa78d555ba3fb366ea42a46c6f","url":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_large.png","height":1400},"medium":{"identifier":"ER01AU03.009","content_type":"image/png","size":57285,"width":403,"sha":"7ed1cacfa7def911ba13ed758714de85","url":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_medium.png","height":686},"original_size":{"identifier":"ER01AU03.009","content_type":"image/png","size":366389,"width":3041,"sha":"6fe38fdbb9242cdfac09c35765d78578","url":"https://img.federalregister.gov/ER01AU03.009/ER01AU03.009_original_size.png","height":5178}}},"json_url":"https://www.federalregister.gov/api/v1/documents/03-19540?publication_date=2003-08-01","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2003-08-01/03-19540/mods.xml","not_received_for_publication":null,"page_length":55,"page_views":{"count":1284,"last_updated":"2026-09-20 20:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2003-08-01/pdf/03-19540.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2003-08-01","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2003/08/01/03-19540.txt","regulation_id_number_info":{"0938-AL95":{"issue":"200304","html_url":"https://www.federalregister.gov/regulations/0938-AL95/prospective-payment-system-for-inpatient-rehabilitation-hospitals-for-fy-2004-cms-1474-f-","title":"Prospective Payment System for Inpatient Rehabilitation Hospitals for FY 2004 (CMS-1474-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200304&RIN=0938-AL95&operation=OPERATION_EXPORT_XML","priority_category":"Substantive, Nonsignificant"}},"regulation_id_numbers":["0938-AL95"],"regulations_dot_gov_info":{},"regulations_dot_gov_url":null,"significant":false,"signing_date":null,"start_page":45674,"subtype":null,"title":"Medicare Program; Changes to the Inpatient Rehabilitation Facility Prospective Payment System and Fiscal Year 2004 Rates","toc_doc":"Hospital inpatient rehabilitative facilities prospective payment system and 2004 FY rates","toc_subject":"Medicare and Medicaid:","topics":["Administrative practice and procedure","Health facilities","Medicare","Puerto Rico","Reporting and recordkeeping requirements"],"type":"Rule","volume":68}