Medicare Part A Therapy Rug Levels

This rug level will impact the amount medicare will reimburse the facility.

Medicare part a therapy rug levels. Prospective payment system and consolidated billing for skilled nursing facilities. Fy 2001 snf pps proposed rule april 1 2000. As part of the mds the number of occupational therapy minutes will be combined with physical and speech therapy to establish a resource utilization group rug level. A week minimum at least 2 disciplines 1 discipline 5 days.

At least 720 minutes. Medicare bases the standardized per diem rates on national data from urban and rural areas. These codes are effective as of october 1 2020. Activities of daily living adl assistance cont adl self performance algorithm start here remember to review the instructions for the rule of 3 and the adl self.

Both the standard medicare part a rug reported in item z0100a and the medicare part a non therapy rug in item z0150a are recorded on the mds 3 0. With category iii extensive services. Updates to the value based. Cms s rai version 3 0 manual ch 3.

The rug levels are. This level is set within three days of the fifth 14 th 30 th 60 th and 90 th days of a patient s. Rehabilitation therapy and was not able to receive 5 days of therapy due to discharge from medicare part a. Spotlight the fy 2021 pdpm icd 10 mappings zip have been updated to reflect non substantive updates to the icd 10 code set for fy 2021 as well as substantive changes finalized in the fy 2021 snf pps final rule.

Slps occupational therapists and physical therapists recommend the frequency and length of sessions that they anticipate a patient will need. Each part a patient s rug is based on an overall assessment of the patient which includes the amount of rehabilitation therapy minutes occupational physical and speech combined the patient needs per week. Case mix and wage adjustments also apply to per diem rates. When rehabilitation services are not provided the standard medicare part a rug will match the medicare part a non therapy rug.

You must assess the clinical condition of snf residents by completing the required mds 3 0 assessments for each medicare resident receiving part a snf level care for reimbursement under the snf pps in a covered part a stay. This is part of the mds information about the patient s needs that is combined to determine the patient s rugs resource utilization groups level. Rug iii v5 12 descriptors for sb mds 2 0 category adl index end splits rug codes 16 18 ruc 9 15 rub rehabilitation ultra high rx 720 mins. Part b add on to account for the estimated cost of services furnished during the fy 1995 base period paid by part b for snf patients during a part a covered stay.