FY 2021 PDPM Rate Updates (effective 10/1/2020) - (Bonus Rate Calculator Included)

October invoicing marks the beginning of FY 2021. CMS has made several adjustments impacting accurate rate calculations - which go into effect with Oct 2020 billing - including:

  • 2.5% PDPM Base Rate Increase

  • Urban / Rural Re-alignment

  • Average Wage Index Update with a cap on the decrease impact to a neg 5%

  • VBP updates are now available at the facility level through Casper reporting – CMS has not released a global report as of this date

QRM has partnered with DataIQ to provide a “PDPM Rate Calculator”.

The attached “FY2021 Part A PDPM Rate Calculator” workbook provides the following information:

FY 2021 PDPM Rate Updates_FY 2021 Part A
Download • 5.11MB

Rate Calculator: Total Revenue and Avg Rate / Day determined once user selects or enters the following prompted data:

  • Facility Name

  • HIPPS Code

  • Stay Start Date

  • LOS

  • SNF VBP Multiplier (end user must pull from internal sources at this point (Casper reporting)

PDPM Updated Base Rates

CMI by HIPPS by Category

2021 Wage Index by Provider

Let's Get to the Point:

Ensure your billing departments and software are utilizing FY 2021 data to bill and receive accurate payments. Every penny does count!
If QRM can help in any way, please let us know.