📊 CMS-Compliant PDPM Calculator

PDPM Rate Calculator

Calculate Patient-Driven Payment Model rates using current CMS FY 2025 guidelines. Get accurate PDPM assessments for skilled nursing facilities with proper case mix methodology.

PDPM Calculator

6 (High Function)24 (Low Function)

Geographic Adjustment

0.80001.8000

PDPM Results

$522.46
Daily PDPM Rate (Adjusted)
Base Rate: $522.46
$15,673.731
Monthly Revenue
$190,697.06
Annual Revenue

PDPM Component Breakdown

Physical Therapy (PT)$68.36 (CMI: 0.99)
Occupational Therapy (OT)$64.53 (CMI: 0.99)
Speech-Language Pathology (SLP)$11.80 (CMI: 1.00)
Nursing$181.60 (CMI: 1.00)
Non-Therapy Ancillary (NTA)$81.83 (CMI: 1.00)
Non-Case Mix$114.34

CMS Guidelines Reminder

This calculator uses FY 2025 CMS rates and approved PDPM methodology. Accurate MDS assessments (especially Section GG function scores and BIMS cognitive scores) are critical for proper reimbursement.

Understanding PDPM

The Patient-Driven Payment Model revolutionizes Medicare reimbursement for skilled nursing facilities.

Patient-Driven

Reimbursement based on patient characteristics and needs

Five Components

PT, OT, SLP, Nursing, and Non-Therapy Ancillary

Variable Length

No therapy minimums or maximums required

Quality Focus

Emphasis on patient outcomes and satisfaction

PDPM Key Features

Classification Variables

  • Primary diagnosis and comorbidities
  • Cognitive and functional status
  • Special care treatments and services
  • Admission source (hospital vs. community)

Payment Components

  • Physical Therapy (PT) Component
  • Occupational Therapy (OT) Component
  • Speech-Language Pathology (SLP) Component
  • Nursing Component
  • Non-Therapy Ancillary (NTA) Component

Optimize Your PDPM Reimbursements

Simpl Healthcare's integrated platform helps you maximize PDPM reimbursements through accurate assessments and comprehensive documentation.