Free · Educational Guides
Guides
Plain-language explanations of how post-acute Medicare payment actually works — the systems behind the calculators. Written for clinicians, billers, and coders who want the why, not just the number.
GUIDE · SKILLED NURSING
How PDPM Works
The SNF grouper end to end — the five components, the variable per-diem schedule, and the HIPPS code.
More guides in progress
SoonSkilled Nursing
The Five PDPM Components
What classifies PT, OT, SLP, Nursing & NTA
SoonSkilled Nursing
Anatomy of a PDPM HIPPS Code
What each of the five characters encodes
SoonHome Health
How PDGM Works
30-day periods and the case-mix logic
SoonHome Health
Understanding LUPA
Per-period visit thresholds & the payment cliff
SoonHospice
How Hospice Payment Works
The four levels of care and the two-tier rate
SoonPart B Therapy
The KX Threshold & Modifier
Therapy thresholds and targeted review
SoonCoding
How Diagnosis Drives Payment
ICD-10's role in PDPM and PDGM