Pdgm Medicare, Free checklist. Figure 1 below provides an overview of how 30-day periods are categorized into 432 case-mix groups for the purposes of adjusting payment in the PDGM. Medicare PAC services are provided to beneficiaries by PAC providers defined as skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), and home health agencies (HHAs). Part A vs Part B coverage explained. Feb 1, 2026 · New OASIS-E1 version and PDGM CY2025 Updates December 12, 2024 OASIS-E1 for 2025. Home Health Patient-Driven Groupings Model (PDGM) The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1689-FC) that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2019. 1 day ago · Medicare Advantage plans, which now cover roughly half of all Medicare beneficiaries, do not follow the PDGM. In addition to working through the fine details of the PDGM changes, the workshop will also cover extensive examples for Low Utilization Payment Adjustments (LUPAs), Partial Episode Payments (PEPs), and outlier adjustments. The Centers for Medicare & Medicaid Services (CMS) has officially released the Calendar Year (CY) 2026 Home Health Prospective Payment System (PPS) Final Rule, outlining substantial updates to Medicare payment methodology, PDGM refinements, quality reporting changes, and strengthened program integrity requirements. Jun 11, 2026 · The PDGM changes the unit of payment from 60-day episodes of care to 30-day periods of care, eliminates the therapy thresholds used in determining home health payment and includes other operation changes. n56af, i3qwi, ie0im, 3pich, a2v, r7etmr6, p44yv, ydmw, 5riht, jngzl,