On April 21, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the FY 2021 Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). The proposed rule includes a 2.9 percent payment increase ($270 million total) which rural areas will experience as an average increase of 3.2 percent. CMS is also proposing to amend the regulations to remove the post-admission physician evaluation requirement and to allow non-physician practitioners to perform certain requirements that currently a rehabilitation physician must perform. The rule also includes a five percent cap on wage index decreases and adopts the most recent Office of Management and Budget statistical area delineations with 34 urban counties becoming rural and 47 rural counties becoming urban. Comments are due on Juen 15, 2020.