1. What is the PDPM Calculator for FY 2024?

Definition: This calculator computes the Patient-Driven Payment Model (PDPM) daily rate for skilled nursing facilities based on the six components of the PDPM system.

Purpose: It helps healthcare administrators and financial analysts determine the reimbursement rate for Medicare Part A patients under the PDPM system.

2. How Does the Calculator Work?

The calculator uses the formula:

Where:

• \( PT \) — Physical therapy component rate
• \( OT \) — Occupational therapy component rate
• \( SLP \) — Speech language pathology component rate
• \( Nursing \) — Nursing component rate
• \( NTA \) — Non-therapy ancillary component rate
• \( Non\text{-}Case\text{-}Mix \) — Non-case-mix component rate

Explanation: The calculator sums all six components to determine the total daily reimbursement rate under PDPM.

3. Importance of PDPM Calculation

Details: Accurate PDPM rate calculation ensures proper Medicare reimbursement and helps facilities maintain financial stability while providing quality care.

4. Using the Calculator

Tips: Enter each component rate in dollars. All values must be ≥ 0. The calculator will sum all components to provide the total daily rate.

5. Frequently Asked Questions (FAQ)

Q1: What is PDPM?
A: The Patient-Driven Payment Model is Medicare's payment system for skilled nursing facilities, implemented in October 2019.

Q2: Are these FY 2024 rates final?
A: This calculator uses the proposed FY 2024 rates. Always verify with the latest CMS updates before final billing.

Q3: How are the component rates determined?
A: Each component is calculated based on patient characteristics, clinical categories, and other case-mix adjusters.

Q4: Does this include the wage index adjustment?
A: No, this calculates the base rate. The wage index adjustment would be applied separately.

Q5: Where can I find the official component rates?
A: Component rates are published annually by CMS in the Federal Register and on the CMS website.