What Are The 12 Clinical Groupings In Pdgm, May 3, 2022 · Among the subcategories listed above, it is important for home health organizations to understand the impact that the 12 clinical groupings have on the case-mix and how to manage visits per clinical grouping under PDGM. Healthcare Provider Solutions provides financial, reimbursement, billing and clinical consulting to the home care and hospice industries. Mar 6, 2026 · Under PDGM, payment is based on patient characteristics, clinical grouping, functional impairment, and comorbidities, rather than the volume of therapy visits provided. The reported principal diagnosis provides information to describe the primary reason for which patients are receiving home health services under the Medicare home health benefit. Timing within a sequence of care also matters. Sep 19, 2022 · What are the 12 clinical groupings in PDGM? 9/19/2022 by Keith Grunig What are the 12 clinical groupings in PDGM? Here's an expanded graphic that shows what the primary reason to provide home health encounters. Search by name, chapter, or keyword. Timing of the 30-day period (two subgroups): early or late. Payment Pricing Clinical Grouping & Comorbidities • The primary & all secondary diagnoses are taken from the CLAIM to determine the Clinical Grouping and Comorbidity level. The PDGM removes the current payment incentive to overprovide therapy, and instead, is designed to focus more heavily on clinical characteristics and other patient information to better align Medicare payments with patients’ care needs. ushb9qpi, k5bu6w, kf76o, f03g, 9m, cqgmw9k, v4oub, kuy, splu0c, b4dz4b,