CMS Publishes Draft IRF-PAI Version 4.4

The Centers for Medicare and Medicaid Services (CMS) has published the draft inpatient rehabilitation facility patient assessment instrument (IRF-PAI) version 4.4. This version of the IRF-PAI becomes effective on October 1, 2026.

This draft version has the following modifications from the current IRF-PAI Version 4.2:

• IRF-PAI Item 8. Gender – has been moved to IRF-PAI Item A0810. Sex.
• IRF-PAI Item 14. Admission Class – has been removed.
• Transportation Item A1250 – has been modified into Transportation Item A1255 with new item verbiage and response options and is only to be collected at admission. Transportation item A1250 has been removed from the discharge assessment.
• Item O0350. Patient’s COVID-19 vaccination is up to date – has been removed from the discharge assessment.

As finalized in the fiscal year (FY) 2026 Final Rule, draft version 4.4 also removes the Section R Social Needs items. The four items removed were social determinants of health (SDoH) data elements related to living situation, food, and utilities, which were previously scheduled to be implemented October 1, 2026.