Revenue Cycle

    PDGM LUPA Threshold

    The PDGM LUPA Threshold is the CMS-assigned minimum visit requirement for a specific HIPPS code

    Definition

    The PDGM LUPA Threshold is the CMS-assigned minimum visit requirement for a specific HIPPS code

    Why it matters

    PDGM LUPA Threshold is part of the Revenue Cycle vocabulary used across home health operations, documentation, and revenue cycle. Understanding it helps clinicians, QA leads, and administrators stay aligned on care quality and compliance.

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