Patient-Driven Payment Model begins 10/1/19. A few frequently asked questions and clarifications.

  • How do I mark A0300a “Optional State assessment” for setting up my transitional IPA assessment?
    • A0300a would be NO- the assessments in this item are for optional assessments that may be required by case-mix states or for those HMO which may continue to require the 14-, 30-, 60-, 90-day or “T” assessments- COT, SOT, etc. To set up the transitional IPA A0310b would be “PPS Unscheduled Assessment for Medicare Part A Stay 08- Interim Payment Assessment
  • What are the assessment days for Section GG on the Transitional IPA assessment?
    • As is with section GG for the PPS Discharge, section GG for the Interim Payment Assessment (A0310B=08), the assessment period for Section GG is the last 3 days (i.e., the ARD and two days prior). Page GG-10.
  • More PDPM FAQ from CMS can be found here:

As always, feel free to contact your QIPMO nurse or Leadership Coach with any further needs or questions!