1. What is a PDPM Calculator for FY 2025?

Definition: This calculator computes the daily rate under the Patient-Driven Payment Model (PDPM) for skilled nursing facilities in fiscal year 2025.

Purpose: It helps healthcare administrators and financial analysts determine the reimbursement rate for Medicare Part A stays in SNFs.

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 PDPM daily rate is the sum of all six components as defined by CMS for FY 2025.

3. Importance of PDPM Calculation

Details: Accurate PDPM rate calculation ensures proper Medicare reimbursement and helps facilities with financial planning and budgeting.

4. Using the Calculator

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

5. Frequently Asked Questions (FAQ)

Q1: Where do I find the component rates?
A: Component rates are published annually by CMS in the SNF PPS Final Rule for each fiscal year.

Q2: Does this include variable per diem adjustments?
A: No, this calculates the base rate. Variable per diem adjustments for NTA and PT/OT would be applied separately.

Q3: Are these FY 2025 rates final?
A: Rates should be verified against the final CMS publication for FY 2025 as they may be updated.

Q4: How often should I recalculate rates?
A: Rates should be recalculated whenever CMS updates the component rates or when patient classification changes.

Q5: Does this account for geographic adjustments?
A: No, wage index adjustments would need to be applied separately to the calculated rate.