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Enhancements to Patient Driven Payment Model (PDPM) Claim Edits to Improve Claim Processing

The purpose of this Change Request (CR) is to update current Skilled Nursing Facility (SNF) PDPM claim processing edits in order to process and pay claims correctly.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 29, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.