Patient Driven Payment Model
70th AHCA/NCAL Convention and Expo
The new Medicare SNF PPS patient driven payment model (PDPM) is based on resident characteristics reported on SNF PPS minimum data set assessments. While the payment model itself has changed, CMS has emphasized that many SNF PPS policies remain unchanged, including SNF coverage criteria and documentation requirements to support skilled level of care as described in Chapter 8 of the Medicare Benefit Policy Manual. This session will detail the key components of the SNF level of care policies and documentation requirements associated with the administrative level of care presumption, daily skilled nursing requirements, daily skilled rehabilitation requirements, and other coverage policies.