1. What is a PDPM Rate Calculator?

Definition: This calculator computes the daily rate under the Patient-Driven Payment Model (PDPM) for skilled nursing facilities in 2023.

Purpose: It helps healthcare administrators and billing professionals determine the reimbursement rate by summing all PDPM components.

2. How Does the Calculator Work?

The calculator uses the formula:

Where:

• \( PT \) — Physical Therapy component
• \( OT \) — Occupational Therapy component
• \( SLP \) — Speech Language Pathology component
• \( Nursing \) — Nursing component
• \( NTA \) — Non-Therapy Ancillary component
• \( Non\text{-}Case\text{-}Mix \) — Non-Case-Mix component

Explanation: All six components are added together to determine the total daily reimbursement rate under PDPM.

3. Importance of PDPM Rate Calculation

Details: Accurate PDPM rate calculation ensures proper Medicare reimbursement and helps facilities understand their revenue streams.

4. Using the Calculator

Tips: Enter each component amount in dollars. All values must be ≥ 0. The calculator sums all components to give 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 2019.

Q2: How are the component rates determined?
A: Each component is calculated separately based on patient characteristics and CMS published rates.

Q3: Are these 2023 rates?
A: Yes, this calculator uses the PDPM component rates effective for 2023.

Q4: Does this include adjustments?
A: No, this calculates the base rate. Additional adjustments (wage index, etc.) would be applied separately.

Q5: Where can I find the official component rates?
A: CMS publishes annual PDPM rates in the Federal Register and on their website.