1. What is a PDPM Rate Calculator?

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

Purpose: It helps healthcare administrators calculate reimbursement rates based on the six PDPM components.

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 PDPM components to determine the total daily reimbursement rate.

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 all six component rates in dollars. Each component should be ≥ 0. The calculator sums these values to provide the total daily rate.

5. Frequently Asked Questions (FAQ)

Q1: What is PDPM?
A: PDPM is the Patient-Driven Payment Model used by Medicare to reimburse skilled nursing facilities since October 2019.

Q2: Are these 2025 rates final?
A: This calculator uses projected 2025 rates. Always verify with the latest CMS updates.

Q3: How do I determine each component rate?
A: Component rates are determined by patient characteristics, clinical categories, and other case-mix adjusters.

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 official PDPM rate information?
A: Visit the CMS website for official PDPM rate information and updates.