Definitions
What does the acronym PDPM mean?
patient-driven payment model
When did PDPM go into effect?
October 1, 2019
What does RUG stand for?
Resource Utilisation Group
How many components to PDPM?
5 (PT,OT, SLP, Nursing, Non-ancillary)
What is Non-ancillary
Conditions, diagnosis and services that are provided to a patient related to their medical complexity.
What is the percentage of group treatment that can be provided?
25% of their total therapy minutes during their Medicare Part A stay.
What is concurrent therapy?
When therapy is provided to 2 patients at the same time, who are engaged in different activities
Who can receive and benefit from individual and group therapy?
ANYONE!!!!
What is group therapy?
When therapy is provided to 2-6 patients that are performing similar activities
Bonus: this is Medicare Part A, Part B only allows 2-4 patients in a group
Which insurance payor doesn't cover concurrent therapy treatments?
Medicare Part B
If a patient receives 800 minutes of therapy how many minutes of group and/or concurrent therapy can they receive?
No more than 200 minutes