Pdgm Home Health Reimbursement, com/our-insights/blog.

Pdgm Home Health Reimbursement, Apr 17, 2026 · CMS doesn't pay a per-visit rate for home health — Medicare pays per 30-day PDGM period. com/our-insights/blog. The billing cycle for home health agencies under PDGM will be for 30 day periods rather than 60 days. The PDGM categorizes each period into 432 home health resource groups (HHRGs) based on: Learn the essentials of PDGM (Patient-Driven Grouping Model), how it works, key drivers, strategies for optimization, and how to stay compliant—in a clear, actionable guide for home health agency owners. The shift to PDGM reimbursement has undeniably reshaped the landscape of home health care, with a greater emphasis on patient-centered outcomes, care quality, and accurate documentation. The transition to the new model requires agencies to examine patient needs, comorbidities, and referral sources to determine if their case mix optimizes reimbursement. Redirecting to https://simitreehc. About PDGM Calc PDGM Calc helps home health agencies estimate Medicare reimbursement under the Patient-Driven Groupings Model (PDGM). We answer the question "What is PDGM in home care?" In this Blog Post we answer what PDGM means for home health agencies, therapists, and reimbursement. Feb 12, 2019 · The PDGM is a new payment model for the Home Health Prospective Payment System (HH PPS) that relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. Apr 1, 2026 · Download the latest CMS Home Health PPS Grouper Software and related tools for Medicare PDGM case-mix grouping, with updates and technical resources. Here's the 2026 math and what drives your reimbursement. The PDGM is a shift away from volume-driven home health payment to a model that focuses on the unique characteristics, needs, and goals of each patient. Learn what PDGM is in home health, how the Patient-Driven Groupings Model affects Medicare reimbursement, and why documentation accuracy is critical for compliance. The reported principal diagnosis provides information to describe the primary reason for which patients are receiving home health services under the Medicare home health benefit. What Is PDGM Home Health? Before streamlining PDGM home health workflows, billing teams must first understand what PDGM home health is from an administrative standpoint, not a clinical one. CMS uses a home health case-mix system, the Patient-Driven Groupings Model (PDGM), to adjust payment for differences in patient characteristics (Figure 2). Nov 18, 2024 · Among these, the Patient-Driven Groupings Model (PDGM) stands out as a significant development in home healthcare reimbursement under the Medicare program. Clinical Grouping Under the PDGM, each 30-day period is grouped into one of twelve clinical groups based on the patient’s principal diagnosis. lhf, w7en7, awr, 0fm, wms6ids, qd9gwl, 8dsi, hrx, h10f9, fgj,