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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Episodes from Inside Home Health that put Payment Adjustment in operational context.
