Billing, News, Payment/economy, Skilled Nursing Facility

Resources for a smooth transition to PDPM

Brought to you by Biller’s Association for Long-Term Care.

As SNF and nursing home providers familiarize themselves with CMS’ new Patient Driven Payment Model (PDPM), The Bottom Line is here to keep you educated and up to date on the latest resources, guidance, and best practices as they are made available. Here are this week’s helpful resources for you to add to your PDPM toolkit.

  • Attend HCPro’s free webinar, Ready or Not: PDPM is Here, led by postacute regulatory specialist Stefanie Corbett, DHA, Wednesday, August 22 from 1:00-1:30pm, ET. Click here to register!
  • Receive hands on education by signing up for one of our billing boot camps. Our 3-day Medicare Boot Camp – Long-Term Care Version in Las Vegas, NV September 17, 18, and 19 covers the latest Medicare rules and regulations and our 2-day Skilled Nursing Facility Billing Boot Camp in Las Vegas, NV October 15 and 16 includes education on billing for Medicare Part A and B, the ins and outs of consolidated billing, and accurately completing the UB-04. Can’t make either of these events? We’ll bring an instructor to you!
  • Re-learn SNF consolidated billing under PDPM. During a 60-minute webinar on Wednesday, September 12, from 1:00-2:00pm, ET, postacute regulatory specialist Stefanie Corbett, DHA, will explain how the new reimbursement rates will be assigned under PDPM as well as how to apply CB requirements when projecting revenue and expenses. Click here for a full agenda and to sign up!
  • Download CMS resources. So far, CMS has published several tools to help you anticipate what reimbursement will look like under the new payment system. These tools are listed on CMS’ SNF PPS Payment Model Research page and include:
  • PDPM Calculation Worksheet for SNFs: A step-by-step worksheet illustrating how a resident is classified for payment purposes and how per diem payment is calculated under PDPM.
  • SNF PDPM Clinical Category Mapping: A crosswalk between the ICD-10 diagnosis and procedure codes and the ten PDPM clinical categories.
  • SNF PDPM Classification Walkthrough: A narrative step-by-step walkthrough that would allow stakeholders to manually determine a resident’s PDPM classification based on the data from an MDS assessment.
  • SNF PDPM Grouper Tool: A spreadsheet-based grouper tool which can be used to test certain combinations of MDS items used to classify residents under the proposed PDPM, and observe their impact on the resident’s PDPM classification
  • SNF PDPM NTA Comorbidity Mapping: A mapping, referenced in the narrative walkthrough file, between ICD-10-CM codes and the comorbidities used for resident classification under the NTA component.

And don’t forget to take a breath, and take a break! We’ve got this.