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June 4, 2019

Update to CGS Home Health PDGM Web Page

CGS first told you about the new Home Health Patient-Driven Groupings Model (PDGM) Web page in a listserv email message on April 11, 2019. In addition to the resources provided by the Centers for Medicare & Medicaid Services (CMS), this page now includes a link to the CGS Overview: Home Health Patient-Driven Groupings Model (PDGM) Web page. This new resource includes the following information.

  • Home Health Prospective Payment System (HH PPS) vs PDGM
  • Claim Filing Elements
  • Health Insurance Prospective Payment System (HIPPS) Code
  • Low Utilization Payment Adjustment (LUPA)
  • Partial Payment Adjustment
  • Outlier Payment

Please share this information with your appropriate staff.

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