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Ep 38: Medicare and Medicaid Policy Updates: RUGS, PDPM, MDS
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Medicare and Medicaid Policy Updates: RUGS, PDPM, MDS
Is Medicare No Longer Paying for OT in SNF?
I’ve seen a lot of concern on social media and in my DMs about potential significant changes to PDPM in Skilled Nursing Facilities, specifically around Medicare no longer paying for OT in SNF. You can rest assured that there have NOT been any major changes to Medicare Part A for therapy but other changes have been made. That’s why this week on The Amplify OT Podcast, I am talking about updates to PDPM in Skilled Nursing Facilities (SNF) and when these changes are set to take place.
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The updates I cover in this episode include:
- CMS finalized that it will no longer support the utilization of RUG payments for Medicaid programs.
- There have not been any cuts to Medicare Part A SNF funding but rather a 4% increase.
- Removal of Section G (former ADL section), integrating some items into Section GG (function and self-care).
- The changing of quality measure scores.
- Changes and modifications around COVID-19 policies.
- ICD 10 Code mapping changes for Parkinson's and COVID-19.
Amplify OT Resources
Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!
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Helpful Links
- Medicare.gov Care Compare
- AOTA: Major Changes to the Minimum Data Set in Skilled Nursing Facilities
- Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System Final Rule - CMS-1779-F | CMS
- Occupational Therapy in Skilled Nursing Facilities
- Amplify OT: SNF Resources
- Ep 5: Patient Driven Payment Model (PDPM) in Skilled Nursing Facilities
- Ep. 9: Patient-Driven Groupings Model (PDGM) in Home Health
- Ep 32: Decoding Medicare's Alphabet Soup: Medicare Plans
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Join the Amplify OT Membership
As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.
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