Visit Threshold
Minimum number of billable skilled visits required during a PDGM 30-day payment period.
Definition
A Visit Threshold is the minimum number of billable skilled visits required during a PDGM 30-day payment period to avoid a LUPA adjustment. CMS assigns a threshold ranging from 2 to 6 visits, depending on the patient's payment group.
Why it matters
Knowing the threshold helps agencies schedule visits appropriately while meeting patient needs and avoiding unnecessary payment reductions.
Home Health Documentation Playbook
The complete guide to OASIS-E, Medicare compliance, PDGM, and AI-assisted documentation. Learn how top agencies reduce documentation time without sacrificing compliance.
Listen While You Read
Conversations on lupa & pdgm
Episodes from Inside Home Health that put Visit Threshold in operational context.
Ep 23Ep 23 · Aug 17, 2026
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Ep 19Ep 19 · Jul 6, 2026
AI Won't Replace Nurses, But Nurses Using AI Will | Timi Abiola
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Ep 20Ep 20 · Jul 13, 2026
The Real Cost of Ignoring Nurse Burnout | Jennifer Johnson
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