Copper Digital
    LUPA & PDGM

    Payment Group

    Final PDGM classification assigned to a patient based on clinical grouping, admission source, timing.

    Definition

    A Payment Group is the final PDGM classification assigned to a patient based on clinical grouping, admission source, timing, functional impairment, and comorbidity adjustment.

    Why it matters

    Each payment group has a unique reimbursement amount and corresponding LUPA threshold.

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    Conversations on lupa & pdgm

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

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