Full PDGM Payment
Standard Medicare reimbursement paid when the patient meets or exceeds the required LUPA visit.
Definition
A Full PDGM Payment is the standard Medicare reimbursement paid when the patient meets or exceeds the required LUPA visit threshold during the 30-day payment period.
Why it matters
Receiving the full payment helps agencies recover the costs associated with patient care, staffing, and operations.
Texas Home Health Payer Contracting Playbook
When a Texas payer says “our network is closed,” it doesn’t mean every door is shut. This playbook explores three paths to pursue payer contracts, access referral networks, and secure out-of-network payments. Learn which three numbers payers check first, and how to build a stronger case for your agency.
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