Therapy Component Rug

Above is a picture of what life is like under rug iv vs.

Therapy component rug. Rug non case mix therapy component non case mix component nursing base rate nta nursing 43 57. Ultra high very high high medium low and therapy non case mix. Resource utilization group rugs system. Since 1998 snfs have been paid under the resource utilization group prospective payment system rug iv pps.

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. One of the basic abcs of pdpm will be the change in case mix components. Adjust the nursing components of state medicaid payment systems one exception. The therapy component is case mix adjusted for.

Texas medicaid adjusts the rug 34 relative risk. The nursing component is case mix adjusted for all rugs. Under rug iv therapy payments are based on the number of days and minutes of services under a single component. 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.

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. An initial set of rugs developed primarily to. A therapy component reflecting the amount of therapy services provided or expected to be provided. The resident s rug was either a therapy rug or non therapy nursing rug.

And a non case mix adjusted component reflecting the costs of room and board linens and administrative services. Lynda jennings otr tota mcc 2019 11 3 18 4 key elements of pdpm. Of the resident and a case mix adjusted non therapy ancillary component. Cms provides nursing and therapy weights that are used along with other component factors to establish person level per diem.

Utilizes the same nursing classification structure as rug iv except there are some modifications. Pdpm component per diem and rug iv rate reference table 4 15 19 update pdpm pt variable per diem payment rate table urban pt case mix group fy 2019 federal per diem rate urban day 1 20 day 21 27 day 28 34 day 35 41 day 42 48 day 49 55 day 56 62 day 63 69 day 70 76 day 77 83 day 84 90 day 91 97 day 98 100.