Therapy Component Rug

Ultra high very high high medium low and therapy non case mix.

Therapy component rug.

Therapy rugs are used to bill over 90 of part a days pdpm moves away from intensity driven model of payment to characteristic need driven model of payment. Lynda jennings otr tota mcc 2019 11 3 18 4 key elements of pdpm. The therapy component is case mix adjusted for. A therapy component reflecting the amount of therapy services provided or expected to be provided.

The nursing component is case mix adjusted for all rugs. Of the resident and a case mix adjusted non therapy ancillary component. And a non case mix adjusted component reflecting the costs of room and board linens and administrative services. Utilizes the same nursing classification structure as rug iv except there are some modifications.

Cms provides nursing and therapy weights that are used along with other component factors to establish person level per diem. The resident s rug was either a therapy rug or non therapy nursing rug. Since 1998 snfs have been paid under the resource utilization group prospective payment system rug iv pps. Under rug iv therapy payments are based on the number of days and minutes of services under a single component.

Adjust the nursing components of state medicaid payment systems one exception. One of the basic abcs of pdpm will be the change in case mix components. Rug non case mix therapy component non case mix component nursing base rate nta nursing 43 57. Texas medicaid adjusts the rug 34 relative risk.

An initial set of rugs developed primarily to. Under rug iv the number of pt ot and slp therapy treatment minutes are combined for a total number of treatment minutes that is used to classify a given patient into a given therapy rug under pdpm patient characteristics will be used to predict the therapy costs associated with a given patient rather than rely on service use. Rug iv includes six therapy payment levels. Under rug iv you have two case mix categories nursing which includes non therapy ancillary services and therapy which includes physical occupational and speech therapy.

Resource utilization group rugs system. 8 tep focused on the therapy component was held in february 2015 nursing index rug session 1 introductions and project overview therapy base rate therapy index rug or rehab non rehab payment rug non case mix therapy.