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Updated thresholds values for functional impairment levels for all clinical groups.

Included in the v04.0.23 software update are: In conjunction with the implementation of the PDGM, the unit of home health payment changed from a 60-day episode to a 30-day period. The PDGM, or Home Health PPS Grouper Software (HHGS), relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds.

In November 2018, CMS finalized a case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. A summary of the changes for what is included in the v04.0.23 HH PPS Grouper software update is listed below. The January 2023 release of the HH PPS Grouper software (v04.0.23) is now available in the “Downloads” section of this webpage.

Home Health PPS Grouper Software (HHGS) Package (for claims starting 1-01-2023)