Next Event: Practical Application of Front End Essentials for Billing
Date: May 28,2025
Therapy Under the Home Health Patient-Driven Groupings Model
The Centers for Medicare and Medicaid Services has released a MLN Matters article that provides information on the continuing role of therapy under the newly implemented home health prospective payment system (HH PPS) case-mix adjustment methodology, named the Patient-Driven Groupings Model (PDGM), for home health periods of care starting on and after January 1, 2020. To access the article, click HERE. I hope you fond this article helpful.
Home Health Patient-Driven Groupings Model
Effective January 1, 2020, home health services will now be reimbursed under a new system called the Patient-Driven Groupings Model (PDGM). The PDGM changes the unit of payment from 60-day episodes of care to 30-day periods of care and eliminates the therapy thresholds for use in determining home health payment. Per the Centers for Medicare and Medicaid Services (CMS), the PDGM will assign 30-day periods of care into one of 432 case-mix groups based on the following variables: • Timing: The first 30-day period of care is an early period of care. The second or later 30-day period of care