Inpatient Rehabilitation Facility Review Choice Demonstration

Published 09/30/2026

Welcome to the Inpatient Rehabilitation Facilities (IRF) Review Choice Demonstration (RCD) home page. The demonstration aims to ease administrative workload for IRFs that consistently comply with Medicare requirements, while providing facilities the flexibility to select the review option that best meets their operational needs. 

Beginning August 21, 2023, Centers for Medicare & Medicaid Services (CMS) implemented the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facility (IRF) services located in Alabama. 

CMS expanded IRF RCD to include IRFs that bill to MAC Jurisdiction JJ, Alabama, Georgia and Tennessee, regardless of where they are physically located with full implementation occurring on December 31, 2026, effective January 1, 2027.

Medicare Administrative Contractors (MACs) are required to review an IRF’s documentation to determine if beneficiaries meet IRF service requirements per 42 CFR 42 CFR 412.622 and the Medicare Benefit Policy Manual, Pub. 100-02, Chapter 1, Section 110 (PDF).

eServices Portal

Palmetto GBA is pleased to offer eServices, our free internet-based, self-service portal. Access Palmetto GBA's eServices portal. You will be able to:

  • Make IRF RCD Choice Selections
  • View IRF RCD choice selection history
  • Submit a pre-claim review request
  • Edit incomplete pre-claim review IRF requests

Web Site Resources

IRF RCD Alabama (AL) Providers – Initial Implementation (Effective August 21, 2023) 

Alabama IRFs have participated in the Review Choice Demonstration since August 21, 2023, and will continue under the existing requirements.

IRF RCD Providers – Jurisdiction JJ Expansion (Effective January 1, 2027)

CMS will expand the IRF RCD to IRFs that bill to MAC jurisdiction JJ, Alabama, Georgia and Tennessee, regardless of where they are physically located, effective January 1, 2027.

IRF providers in these states will be able to make their review choice selection — either 100% pre-claim review or 100% post-payment review — during the designated selection period prior to implementation.

IRF providers can make their review choice selection at the Palmetto GBA Provider Portal on the following dates:

  • Selection Period Start Date: November 13, 2026
  • Selection Period End Date: December 14, 2026
  • Cycle 1 Start Date: January 1, 2027
  • Cycle 1 End Data: June 30, 2027

Important Dates

  • Calculation Period: July 1–15, 2027
  • Results Letters: July 16–31, 2027

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