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.
- Interactive Grouper tool on HHA Center webpage
- PDGM Case Mix Weights and LUPA Thresholds [ZIP, 45KB] and PDGM Agency Level Impacts [ZIP, 938KB]
- CY 2019 Home Health Final Rule on Federal Register
- MLN Matters Article MM11081- PDGM - Split Implementation
- 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.
- Page last Modified: 09/11/2019 1:31 PM
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