PDPM RESOURCES

The Patient-Driven Payment Model (PDPM) will start on October 1.  This is less than one week away!  Below are some resources that help you become as prepared as possible for this drastic change in Medicare reimbursement.

The American Health Care Association (AHCA) has recently made several resources available for their member facilities:

·    An improved PDPM Grouper Version 2.0 with clearer “how to use instructions” as well as a simplified workbook.
·    Archived Monthly Webinars

The Centers for Medicare & Medicare Services (CMS) has numerous resources available as well.

MDS 3.0 RAI Manual – The final RAI manual, version 1.17.1, has been posted. This version of the MDS 3.0 RAI Manual incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas. Since the preliminary release of the manual on May 20, 2019, changes have been made to clarify which assessments swing bed providers must complete; the definition of the “interruption window” for interrupted Part A-covered stays; the coding of item I0200B; and changes related to group therapy policies, as well as other corrections.

This latest version is available here