US · guidance
CMS Pub. 100-04, ch. 3, § 140.2.5.4
Teaching Status Adjustment
The teaching status adjustment is a facility level adjustment made to the Federal
per discharge base rate to account for the higher indirect operating costs
experienced by facilities that participate in graduate medical education. The
adjustment is made on a claim basis as an interim payment, with final payment in
full for the cost reporting period made through the cost report. Any difference
between the interim payments and the actual teaching status adjustment amount
computed in the cost report are adjusted through lump sum
payments/recoupments when the cost report is filed and later settled. The
adjustment is based on the IRF’s “teaching variable,” which is the ratio of the
number of FTE residents training in the IRF (subject to the FTE resident cap
described below) to the IRF’s average daily census (ADC).
History
(Rev. 2673, Issued: 03-14-13, Effective: 04-22-13, Implementation: 04-22-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a3d7e5446aba29afe22f5eb506f972415d165d8a7a10188d0aa384b4f219f584
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