This is the third of four articles dealing with the patient-driven payment model (PDPM). Under PDPM each patient is classified into a group for each of the five case-mix adjusted components. The payment for each of the case-mix adjusted components is calculated by multiplying the case-mix indicator by the base rate in each group and then taking into consideration the variable per diem schedule when applicable.
Our first article reviewed the physical therapy, occupational therapy and speech language pathology components. The second article reviewed the nursing components. This article reviews the nontherapy ancillaries (NTA) component. The NTA component is determined based on the presence of certain conditions and comorbidities. There are 50 conditions and extensive services that contribute to the NTA payment calculations. Some comorbidities are associated with higher costs and are assigned into higher point tiers while those associated with lower costs are grouped into lower point tiers. Here is a listing of those comorbidities with their assigned points: