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The PDPM is a shift away from volume-driven SNF payment to a model that focuses on the unique characteristics, needs, and goals of each patient.

Medicare’s Patient-Driven Payment Model was implemented in October 2019 to improve payment accuracy by addressing each patient's circumstances independently and classifying patients into payment groups based on specific, data-driven patient characteristics. PDPM redefines the relationship between payment and quality measures, realigning payment incentives and quality incentives.

The implementation of PDPM makes it ever more important to show the value and cost-effectiveness of physical therapist services within skilled nursing facilities.

Claims that the PDPM itself mandates reductions in care simply aren't true. Similarly, assertions that the new system requires maximum use of group therapy, sets out productivity requirements, limits medically necessary therapy service, and dictates which therapy disciplines provide care based on payment categories are not accurate. These myths should not be the basis for any changes to facility protocols that impact patient care.

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Final CMS Rule for SNFs: a 2.2% Increase and Ongoing Monitoring of PDPM

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Additional Patient Driven Payment Model Content

Study: 'Profit-Maximizing' SNFs Were Quick to Decrease Staffing After PDPM

Jan 17, 2023 / Article

Researchers analyzed the effects of the Patient-Driven Payment Model payment system — and the pandemic — on therapy staffing in SNFs.

Final SNF, IRF 2022 Rules: Slight Payment Bumps, Big DMEPOS Win

Aug 10, 2021 / Review

CMS also hasn't decided how it will address a 2020 PDPM payment spike. The rules are effective Oct. 1.

Misuse of SNF and HHA Payment Systems

May 15, 2020 / News

APTA is taking concerns about PDPM and PDGM misapplication directly to physician and consumer groups.

The New Postacute Care Payment Systems: 5 Tips to Help You Find Your Way

Dec 11, 2019 / Analysis

PDPM and PDGM are here, and PTs and PTAs must now learn how to navigate the changed landscapes.

APTA: New SNF Payment System Should Drive Quality Patient Care, Not Staff L...

Oct 9, 2019 / News

APTA is working to debunk myths surrounding the PDPM payment system.

Final SNF Rule Sets New Payment System Into Motion October 1

Jul 31, 2019 / News

CMS' SNF final payment rule proceeds with implementation of the Patient-Driven Payment Model (PDPM).

SNF, IRF Final Rules Follow Through on Proposed Shifts in SNF Payment Syste...

Aug 1, 2018 / News

The final 2019 rules for SNFs and IRFs are substantially similar to what CMS proposed in the spring, but that's not to say PTs should assume it's a "same rule, different year" situation.