WebMar 23, 2024 · Under PDGM, there will be 432 home health resource groups (HHRGs). That’s far more than the 153 that exist under PPS. Agencies should examine Table 32 in the 2024 PPS final rule to determine how many visits an agency must provide for an episode to not be a LUPA. The highest LUPA threshold under PDGM would be six visits in a 30-day period. WebSep 4, 2024 · The Centers for Medicare & Medicaid Services (CMS) has expanded the number of payment groups from 153 to 432. The flow chart CMS created to describe …
Patient-Driven Groupings Model APTA
WebUnder PDGM, 30-day periods are placed into subgroups for each of these categories: Admission source Subgroups: ... If the primary diagnosis doesn’t fit into one of the 12 clinical groups, it’s considered an "Unacceptable Diagnosis" (formerly “Questionable Encounters”). According to CMS, that means that the patient’s diagnosis isn ... WebSep 24, 2024 · PDGM Clinical Group Changes That Impact You. The annual ICD-10-CM changes through the Centers for Medicare and Medicaid Services (CMS) go into effect on … the ark 2012
What SLPs Need to Know About the New Medicare Home Health …
WebMar 28, 2024 · Summary of the visit thresholds and related number of HHRGs and top clinical groups, under the current PDGM guidance as provided by Medicare. *Medication Management Teaching and Assessment (MMTA) It is important that you prepare in order for your agency to be ready for the implementation of this new payment structure. WebJun 17, 2024 · Each of the 432 payment groups under the PDGM has an associated case-mix weight and Low Utilization Payment Adjustment (LUPA) threshold. CMS’ policy is to annually recalibrate the case-mix weights and LUPA thresholds using the most complete utilization data available at the time of rulemaking. WebMar 29, 2024 · 30-day periods are categorized into 432 case-mix groups for the purposes of adjusting payment under the PDGM. In particular, 30-day periods are placed into different … the gift gobekli tepe