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 2024.

Purpose: It helps healthcare administrators and billing professionals determine the appropriate reimbursement rate based on patient characteristics and services provided.

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, each determined by specific patient characteristics and service needs.

3. Importance of PDPM Rate Calculation

Details: Accurate PDPM rate calculation ensures proper reimbursement for skilled nursing services and helps facilities maintain financial stability.

4. Using the Calculator

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

5. Frequently Asked Questions (FAQ)

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

Q2: How are the component rates determined?
A: Each component rate is calculated based on patient assessment data (MDS) and CMS-established formulas.

Q3: Are these 2024 rates final?
A: This calculator uses the most current available rates. Always verify with the latest CMS updates.

Q4: Does this include variable per diem adjustments?
A: No, this calculates the base rate. Variable per diem adjustments would be applied separately.

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