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2021-05-27

What is the purpose of PDPM?

What is the purpose of PDPM?

What is PDPM? The Patient-Driven Payment Model (PDPM) is the proposed new Medicare payment rule for skilled nursing facilities. It is intended to replace the current RUG-IV system with a completely new way of calculating reimbursement.

What is CMG rehab?

A case mix group (CMG) is used in patient classification system to group together patients with similar characteristics. Case mix groups are used as the basis for the Health Insurance Prospective Payment System (HIPPS) rate codes used by Medicare in its prospective payment systems.

What is a CMG score?

A Case Mix Group score is calculated automatically when you enter a completion date. You can also calculate a score at any time by clicking the Calculate button.

What is the IRF Pai?

The IRF-PAI is the assessment instrument IRF providers use to collect patient assessment data for quality measure calculation and payment determination in accordance with the IRF Quality Reporting Program (QRP).

What is the CPT code for inpatient rehab?

For inpatient consultations, including those in a nursing facility, see codes 99251–99255. For inpatient care other than consultations or follow-up consultations, see the subsequent hospital care codes (99231–99233).

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What is procedure code 99251?

Code Lists 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making.

What does CPT code 99221 mean?

CPT® 99221, Under New or Established Patient Initial Hospital Inpatient Care Services. The Current Procedural Terminology (CPT®) code 99221 as maintained by American Medical Association, is a medical procedural code under the range – New or Established Patient Initial Hospital Inpatient Care Services.

Is an IRF a hospital?

IRFs are free standing rehabilitation hospitals and rehabilitation units in acute care hospitals. They provide an intensive rehabilitation program and patients who are admitted must be able to tolerate three hours of intense rehabilitation services per day.