IRF RCD Cycle Transition: Moving from Cycle 5 to Cycle 6

Published 09/14/2026

As the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facility (IRF) services in Alabama continues, here is what providers should know about transitioning to Cycle 6.

If an IRF’s full affirmation rate or claim approval rate is 90 percent or greater for the previous six-month period, they may choose one of the subsequent review options:

  • Choice 1: Start or continue participating in pre-claim review (PCR) for another cycle
  • Choice 3: Selective post-payment review of a statistically valid random sample (SVRS) of claims every six months
  • Choice 4: Spot Check Review of five percent of claims every six months to ensure continued compliance

Note: If an IRF is eligible for a subsequent review option but does not make a selection during the selection period, the IRF will be placed in Choice 3.

If an IRF’s full affirmation rate is less than 90 percent for the previous six-month period, it may choose one of the initial review options:

  • Choice 1: Continue participating in PCR for another cycle
  • Choice 2: 100 percent post-payment review

Note: If an IRF is eligible for an initial review option but does not make a selection during the selection period, the IRF will be placed in Choice 2.

Providers will continue in their current Cycle 5 option during the calculation and choice selection period. Palmetto GBA will calculate PCR affirmation/claim approval rates from November 1, 2026, through November 15, 2026, and send results letters to providers from November 16, 2026, through November 30, 2026. The choice selection period for Cycle 6 will take place from December 1, 2026, through December 14, 2026. IRFs that do not make a selection during that time period will default to either Choice 2 or Choice 3 as noted earlier in this article. 

Important Dates

  • Calculation Period: November 1–15, 2026
  • Results Letters Sent: November 16–30, 2026
  • Provider Choice Selection Period: December 1–14, 2026

As providers transition from Cycle 5 to Cycle 6, please be advised of the actions required when changing from one choice to another.

Table 1: Actions During Transition
If Your
Cycle
5 Choice was:
And Your Cycle 6 Choice is: Here are the actions you will need to take:
Choice 1: PCR Choice 1: PCR
  1. Continue PCR process. Data from November and December will be included in the Cycle 6 results.
Choice 1: PCR Choice 2: Post-Payment Review
  1. Continue to submit PCR requests through 12/31/2026. Data from November and December will be included in the Cycle 6 results.
    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
    2. Respond to all ADRs generated for current cycle (ADRs will generate through 12/31/2026)
  2. As of 1/1/2027 (Cycle 6 start date), submit final claims.
    1. Final bill will adjust, and the ADR will generate
    2. Respond to ADR

Choice 1: PCR

Choice 3: Selective Pos-Payment Review

  1. Continue to submit PCR requests through 12/31/2026. Data from November and December will be included in the Cycle 6 results.
    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
    2. Respond to ADRs as generated
  2. As of 1/1/2027 (Cycle 6 start date), submit final claim for payment
    1. Final bill will be adjusted, and the ADR will generate
    2. Respond to ADR

Choice 1: PCR

Choice 4: Spot Check

  1. Continue to submit PCR requests through 12/31/2026. Data from November and December will be included in the Cycle 6 results.
    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
    2. Respond to ADRs as generated
  2. As of 1/1/2027 (Cycle 6 start date), submit final claim for payment
    1. ADR will generate
    2. Respond to ADR

Choice 2: Post-Payment Review

Choice 1: PCR

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.
  2. Begin submitting PCR requests on 1/1/2027 for any claim that will be submitted on or after 1/1/2027.
    1. Add UTN to claims with PCR requests

Choice 2: Post-Payment Review

Choice 2: Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results. 

Choice 2: Post-Payment Review

Choice 3: Selective Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.

Choice 2: Post-Payment Review

Choice 4: Spot Check

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results. 

Choice 3: Selective Post-Payment Review

Choice 1: PCR

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.
  2. Begin submitting PCR requests on 1/1/2027 for any claim that will be submitted on or after 1/1/2027.
    1. Add UTN to claims with PCR requests

Choice 3: Selective Post-Payment Review

Choice 2: Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.

Choice 3: Selective Post-Payment Review

Choice 3: Selective Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.

Choice 3: Selective Post-Payment Review

Choice 4: Spot Check

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.

Choice 4: Spot Check Review

Choice 1: PCR

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.
  2. Begin submitting PCR requests on 1/1/2027 for any claim that will be submitted on or after 1/1/2027.
    1. Add UTN to claims with PCR requests

Choice 4: Spot Check Review

Choice 2: Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results. 

Choice 4: Spot Check Review

Choice 3: Selective Post-Payment Review

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results.

Choice 4: Spot Check Review

Choice 4: Spot Check

  1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 6 results. 

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