Patient-Driven Payment Model (PDPM)

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.

Finetune Section GG Coding to Prevent Inaccurate Payments

Posted By: Caralyn Davis, Staff Writer
Post Date: 08/01/2019

In the current RUG-IV case-mix classification system used in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS), the activities-of-daily living (ADL) score derived from MDS section G (Functional Status) factors into the calculation of every case-mix group. Effective October 1, that all changes. While section G will still be important for care planning and some quality measures (QMs), section GG (Functional Abilities and Goals) will take over on the payment front, providing functional scores that will be used in case-mix classification for three of the five case-mix-adjusted payment components under the new Patient-Driven Payment Model (PDPM): physical therapy (PT), occupational therapy (OT), and nursing.

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