Therapy Component Rug Rate

On july 31 2018 the fiscal year 2019 fy19 medicare skilled nursing facility snf final rule was released by the centers for medicare and medicaid services cms.

Therapy component rug rate.

Pt and ot components receive 100 of base per diem rate for days 1 20 of a stay. You can use it to view your facility s rates. Physical therapy pt occupational therapy ot speech therapy st nursing and non therapy ancillary nta. Cms s rai version 3 0 manual ch 3.

You can use it to view your facility s rates. The nta component is based on the presence of comorbidities and extensive services received. Rug assignments weights are applied at the individual level but the average relative risk of a facility s residents is typically used to adjust the nursing components of state medicaid payment systems one exception. Under the old system rug iv there were two case mix adjusted components.

Fy 2020 unadjusted federal rates per diem rate component pdpm urban rural. 9 therapy tep has been a valuable resource recommendations from the therapy tep have been implemented in ongoing analyses and will inform planned. In rural facilities the nursing component base rate is 167 45 the therapy component is 152 24 and the other component is 91 11. Nursing case mix adjusted 181 44 173 34 therapy case mix adjusted 136 67 157 60 therapy non case mix adjusted 18 00 19 23 non case mix adjusted 92 60 94 31.

Texas medicaid adjusts the rug 34 relative risk weights to reflect local practice to establish person level payments. Nta component receives 300 of the base per diem rate for days 1 3 of a stay. Daily payments to snfs are determined. Therapy provides their minutes nursing works on their adls and the facility gets paid a per diem rate.

In the skilled nursing profession we have grown accustomed to this model since 1998. Beginning day 4 through the remainder of the stay the nta component receives 100 of the base per diem rate. Unadjusted federal rates per diem rate component rug iv urban rural. Areas the nursing component base rate is 175 28 the therapy component base rate is 132 03 and the other component is a uniform 89 46 regardless of the case mix group.

Under pdpm there are five case mix components. Mds items g october 2014 page g 8 g0110. The 2020 snf pdpm rate calculator is now available. Therapy based on volume of services or non case mix base rate nursing does not reflect variations in non therapy ancillary use.

All residents are now classified into one of six nta case mix groups and payment for nta services are broken out from nursing services as currently is done under rug iv.