A new change request from CMS implements the policies of the Patient-Driven Groupings Model (PDGM) and provides additional clarity about how the model will work.
 
Change Request (CR) 11081 was released Feb. 1 — 11 months before PDGM is slated to take effect.
 
“A lot of the information in the CR is technical in nature — things like record layouts and screen mockups — that are intended for our system maintenance contractors and for our [Medicare Administrative Contractors],” a CMS official said during a Feb. 13 home health, hospice and durable medical equipment open door forum. “But we wanted to share all the information available so home health agencies and their software vendors have a sense of what’s going on behind the scenes.”
 
Agencies should pay close attention within the change request to billing instruction revisions in Chapter 10 of the Medicare Claims Processing Manual, the CMS official added.
 
Note that because the change request was published so far in advance of PDGM, it’s possible that portions of it may be revised later “to better help [agencies] understand what’s going on,” according to the official.
 
Related link: View CMS’ change request at https://go.cms.gov/2RIQQXJ.