Overview materials available for SNF Patient Driven Payment Model

On Oct. 1, 2019, the new Patient Driven Payment Model (PDPM) will replace the Resource Utilization Group, Version IV (RUG-IV) for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).

The Center for Medicare & Medicaid Services (CMS) hosted a call for providers Dec. 11 to give an overview of PDPM and answer any questions from the audience. The event materials and presentation can be found here.

All providers must complete an interim payment assessment (IPA), with an assessment reference date (ARD) that is no later than Oct. 7, 2019, for all SNF Medicare Part A patients, in order to receive a Health Insurance Prospective Payment System (HIPPS) code that can be used for billing on PDPM’s implementation date. CMS also stressed that all RUG-IV rules continue to apply for all billing prior to PDPM’s Oct. 1, 2019, start date.

The South Dakota Association of Healthcare Organizations will continue to offer webinars and more education to members regarding the transition to PDPM.