Home Health Patient-Driven Groupings Model
In November 2018, CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. In conjunction with the implementation of the PDGM, there will be a change in the unit of home health payment from a 60-day episode to a 30-day period.
- CY 2020 Home Health Final Rule with Comment Period
- CY 2020 Interactive Grouper Tool (ZIP)
- CY 2020 PDGM Case Mix Weights and LUPA Thresholds (ZIP)
- CY 2020 PDGM Agency Level Impacts (ZIP)
- CY 2019 Home Health Final Rule with Comment Period
- MLN Matters Article MM11081- PDGM - Split Implementation (PDF)
- PDGM - Split Implementation - Change Request 11081
- Home Health Patient-Driven Groupings Model National Provider Call – February 12, 2019
- Home Health Patient-Driven Groupings Model: Operational Issues Call – August 21, 2019
- Home Health Agency Center Spotlights
- For additional assistance, home health agencies may submit questions to the following email address: HomehealthPolicy@cms.hhs.gov.