Therapy Component Rug

Cms provides nursing and therapy weights that are used along with other component factors to establish person level per diem.

Therapy component rug.

And a non case mix adjusted component reflecting the costs of room and board linens and administrative services. 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. A therapy component reflecting the amount of therapy services provided or expected to be provided.

Rug iv includes six therapy payment levels. Of the resident and a case mix adjusted non therapy ancillary component. The nursing component is case mix adjusted for all rugs. 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.

Ultra high very high high medium low and therapy non case mix. Above is a picture of what life is like under rug iv vs. 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. 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.

Utilizes the same nursing classification structure as rug iv except there are some modifications. 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. Texas medicaid adjusts the rug 34 relative risk. Both pt and ot components will have individual cmis for payment whether therapy is provided or not since therapy days and minutes do not play a role in payment calculations under pdpm as it does in the current rug iv pps payment system.

One of the basic abcs of pdpm will be the change in case mix components. The resident s rug was either a therapy rug or non therapy nursing rug. An initial set of rugs developed primarily to. Since 1998 snfs have been paid under the resource utilization group prospective payment system rug iv pps.

Resource utilization group rugs system. Rug non case mix therapy component non case mix component nursing base rate nta nursing 43 57.