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Patient Driven Payment Model resources available, informational call scheduled

In July 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a new case-mix classification model called the Patient Driven Payment Model (PDPM). The PDPM, which will be effective Oct. 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.

CMS developed a variety of education and training resources to assist stakeholders in preparing for PDPM implementation. The website includes a variety of educational and training resources to assist stakeholders in preparing for the PDPM implementation, including:

  • FAQs
  • Fact sheets
  • PDPM Training Presentation
  • Implementation tools (including PDPM GROUPER logic)

CMS will also host a provider call on Dec. 11 from 1:30 – 3:00 p.m. ET to provide an overview of PDPM, including the new case-mix classification system for SNF Part A beneficiaries, as well as the changeover from RUG-IV to PDPM. Register for the call.

For more information, review the fiscal year 2019 SNF PPS final rule here. A question and answer session will follow the presentation, however attendees may email questions in advance to PDPM@cms.hhs.gov with “December 11 Call” in the subject line. Submitted questions may be addressed during the call or used for other materials following the call.

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