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 CMS Unveils New PDPM Website, Fact Sheets

The Centers for Medicare & Medicaid Services (CMS) has launched a Patient-Driven Payment Model (PDPM) education website, which includes fact sheets and other implementation tools for the new skilled nursing facility (SNF) payment system that goes into effect Oct. 1, 2019.

CMS said the PDPM would be used from that date under the SNF Prospective Payment System (PPS) for classifying patients in a covered Medicare Part A stay.

In the run-up to the transition to the new PDPM, SNFs and other stakeholders are undertaking a significant retooling and relearning of how reimbursement will work come next year.

The importance of being prepared for the switchover was exemplified by the advice of Mark Parkinson, president and chief executive officer of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) last month.

He told attendees of the 69th Annual AHCA/NCAL Convention & Expo, “Long term care providers should focus on three areas to remain successful in this challenging environment. It is vital to prepare for the Patient-Driven Payment Model, continue to improve quality in our buildings, and remain politically active.”

Among the issues the CMS fact sheets cover are administrative level of care presumption under the PDPM, functional and cognitive scoring, Minimum Data Set changes, concurrent and group therapy limit, interrupted stay policy, and variable per-diem adjustment.

There is also a section of the website dedicated to frequently asked questions, a training presentation, and a PDPM classification walkthrough and ICD-10 clinical category crosswalk.

In addition to the availability of new online materials, CMS said it will be conducting a SNF PPS – New Patient-Driven Payment Model call on Tuesday, Dec. 11, from 1:30 to 3:00 pm ETTo register, link at Register.

Find the new information at

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