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PDPM Virtual Workshop
PDPM Game Plan
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The Patient-Drive Payment Model (PDPM) is here, and AANAC will continue to help you through the transition. Visit this page frequently for new tools, education, and resources for ongoing success under PDPM.
While no new items in section K of the MDS are expected this October, the Patient-Driven Payment Model (PDPM) is a game changer and some of the existing section K items are going to get a lot more attention. While swallowing and nutritional status have always been important for care areas and care planning, starting October 1, section K steps into the reimbursement spotlight for the speech-language pathology (SLP) component of PDPM. Not to mention, other key MDS items, like parenteral/IV feedings, tube feeding, and intake by artificial route, which currently impact reimbursement, will have even more pull under PDPM.
Despite what appeared to be finalized in the fiscal year (FY) 2019 skilled nursing facility prospective payment system (SNF PPS) final rule, I8000 (additional active diagnoses) will not play any role in determining the primary diagnosis clinical category for the physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) components of the patient-driven payment model (PDPM) that will implement on Oct. 1, 2019. Instead, new item I0020B, in conjunction with relevant new surgical history items J2100 – J5000, will drive the primary clinical category for PT, OT, and SLP, said officials with the Centers for Medicare & Medicaid Services (CMS) during the Dec. 11 SNF PPS: PDPM National Provider Call. Note: Access the call slides, as well as a transcript and recording, here.