Model PDPM reimbursement & data collection with your SNF team.

The PDPM Analyzer is an innovative tool that promotes accurate and optimal reimbursement by predicting Medicare A PDPM rates pre-admission, tracking the Medicare A rate during the stay and can be used as a tool to assist in determining when an IPA assessment would be beneficial. This tool is preloaded with the FY 2021 CMG rates which took affect October 1st, 2020. Click below to download the the tool. 

  • Model and track PDPM reimbursement rates

  • Assure accurate data collection methods

  • Review patient classification prior to MDS submission

  • Validate potential impacts of an optional IPA

optimize accurate PDPM reimbursement

The PDPM Analyzer allows you to classify a skilled Medicare Part A patient into a PDPM Case Mix Grouper (CMG) for each of the 5 components with your Interdisciplinary Team.  Using the digital tool, you will identify the Case Mix Index (CMI) for each and the Case Mix adjusted per diem rate for each component will be automatically calculated based on your facility CBSA (Urban or Rural). A Total Case Mix Adjusted Rate will be calculated for your reference.

assure accurate data collection methods

In order to optimize the plan of care for a patient, Medicare Part A patient classification under PDPM should be completed as early as possible. The tool was designed to allow interdisciplinary SNF teams to practice and model data collection for proper classification so that you are able to assure accurate reimbursement.

​Teams can start with modeling after the 5 Day has been completed and as you get comfortable with the data, you can begin earlier and earlier, working towards beginning on day one. The earlier the information is gathered and you can estimate the patient's CMG for each component, your chances of improving the patient's outcome increase.


The contents of this toolkit are assembled and customized for each SNF to allow leadership and interdisciplinary teams to model reimbursement and simulate new data collection requirements to optimize outcomes under PDPM.

The PDPM Analyzer Includes:

  • Interactive modeling tool, loaded with facility-specific CBSA data

  • Clinical category mapping tool

  • Guides for coding requirements for accurate reimbursement

  • GG Function Score Calculator

  • PDPM references 

  • Strategic considerations and additional tool functions