Medicare Rug Levels Minutes

Mds items g october 2014 page g 8 g0110.

Medicare rug levels minutes. A week minimum at least 2 disciplines 1 discipline 5 days 2nd at least 3 days. 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. For each therapy discipline the total minutes used for rug iv classification include all minutes in individual therapy one half of the minutes in concurrent therapy although total minutes received are documented on each resident s mds and all minutes in group therapy. Cms s rai version 3 0 manual ch 3.

Under rug iv the number of pt ot and slp therapy treatment minutes are combined for a total number of treatment minutes that is used to classify a given patient into a given therapy rug under pdpm patient characteristics will be used to predict the therapy costs associated with a given patient rather than rely on service use. Patients who receive fewer than the required minutes will be lowered to the next rug level. For medicare part a there is a limitation that the group minutes. Effective october 1 2015 excel.

Effective october 1 2017 excel. If eight or more minutes are left over you can bill for an additional unit. A federal government website managed by the centers for medicare medicaid services 7500 security boulevard baltimore md 21244. 4 8 rua 16 18 rvc 9 15 rvb.

Effective october 1 2014 excel. But if seven or fewer minutes remain medicare will not reimburse you for another full unit and you must essentially drop the remainder. The minutes that define a rug level are a minimum not a maximum. In other words medicare adds up the total minutes of skilled one on one therapy direct time and divides the resulting sum by 15.

Medicare part a s exact minutes filter to the mds to determine a rug score for reimbursement. There is no medicare penalty if a patient exceeds the number of minutes in the rug in a particular week. 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. Effective october 1 2016 excel.

Medicare part b s exact minutes filter into a formula to determine unit blocks of time which are then paid using a fee per unit according to the physician fee schedule. The more minutes the higher the category and reimbursement rate.