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Health Patient Driven Groupings Model

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Overview of the Patient-Driven Groupings Model (PDGM)

www.cms.gov

Feb 12, 2019 · Patient-Driven Groupings Model (PDGM) • 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.

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Understanding Diagnosis Coding in PDGM for Compliance …

www.nahc.org

Patient-Driven Groupings Model (PDGM) 9 PDGM Coding Impacts 10. 9/25/2019 6 Coding Impact on PDGM Groupings Model • 2 of the 5 categories are based on the diagnoses coding ... Behavioral Health Care Assessment, treatment and evaluation of psychiatric and substance abuse conditions Complex Nursing Interventions ...

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CMS Manual System

www.cms.gov

adjustment methodology, the Patient-Driven Groupings Model (PDGM), also finalized in the CY 2019 HH PPS Final Rule. Payment under the PDGM is adjusted by patient characteristics and other information obtained from home health claims, other Medicare claims, and certain items from the Outcome and Assessment Information Item Set (OASIS).

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