Patient Driven Payment Model
In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. This site includes a variety of educational and training resources to assist stakeholders in preparing for PDPM implementation.
This section includes fact sheets on a variety of PDPM related topics.
- Administrative Level of Care Presumption under the PDPM
- PDPM Payments for SNF Patients with HIV/AIDS
- Concurrent and Group Therapy Limit
- PDPM Functional and Cognitive Scoring
- Interrupted Stay Policy
- MDS Changes
- NTA Comorbidity Score
- PDPM Patient Classification
- Variable Per Diem Adjustment
PDPM Frequently Asked Questions
This section contains frequently asked questions (FAQs) related to PDPM policy and implementation.
- PDPM FAQs updated 4-17-19
PDPM Training Presentation
This section includes a training presentation which can be used to educate providers and other stakeholders on PDPM policy and implementation.
This section includes additional resources relevant to PDPM implementation, including various coding crosswalks and classification logic.
- PDPM Classification Walkthrough updated 4-4-19
- PDPM GROUPER Logic (SAS) updated 4-4-19
- PDPM ICD-10 Mappings updated 4-4-19
- Page last Modified: 05/16/2019 2:14 PM
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