LUPA & PDGM

    Payment Adjustment

    Modification to the standard Medicare reimbursement amount based on specific program rules.

    Definition

    A Payment Adjustment is a modification to the standard Medicare reimbursement amount based on specific program rules, such as LUPA, outlier payments, wage index adjustments, or sequestration.

    Why it matters

    Understanding payment adjustments helps agencies anticipate reimbursement changes and manage financial performance.

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    Conversations on lupa & pdgm

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