Skilled Nursing Patient Driven Payment Model

Published 01/11/2022

Under PDPM, the HIPPS code is structured differently, as a result of there being five case-mix adjusted rate components under the revised model. The first position represents the Physical and Occupational Therapy case-mix group. The second position represents the Speech-Language Pathology case-mix group. The third character represents the nursing case-mix group. The fourth character represents the Non-Therapy Ancillary (NTA) case-mix group. The fifth character represents the AI code.

PDPM Calculator
VBP should be a number between to

Skilled Nursing/Swing Bed PDPM Calculation

MSA Wage Area Urban/Rural Quality Data SNF VBP Ratio HIPPS Code
Date RangeDaily RateDays in RangeTotal Rate

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