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    LUPA & PDGM

    Patient-Driven Groupings Model (PDGM)

    PDGM is Medicare's payment methodology for home health services.

    Definition

    PDGM is Medicare's payment methodology for home health services. It determines reimbursement based on patient characteristics-including diagnosis, admission source, functional impairment, and comorbidity adjustment-rather than the volume of therapy visits.

    Why it matters

    PDGM introduced variable LUPA thresholds and changed how agencies manage care planning and reimbursement.

    Listen While You Read

    Conversations on lupa & pdgm

    Episodes from Inside Home Health that put Patient-Driven Groupings Model (PDGM) in operational context.

    All episodes
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