Home Health · Calculator

LUPA Calculator

Check whether a 30-day period falls below its LUPA threshold, and estimate the per-visit payment — including the first-visit LUPA add-on — when it does.

LUPA threshold for this group

Threshold (visits)

2–7 per case-mix group

Each of the 432 case-mix groups has its own threshold — the higher of 2 visits or the 10th percentile of visits. Look up the exact value for the period's HIPPS in the CMS LUPA threshold table.

Projected visits by discipline

Skilled Nursing

Physical Therapy

Occupational Therapy

Speech-Language Pathology

Medical Social Services

Home Health Aide

First-visit LUPA add-on

First skilled discipline

Only or initial 30-day period in the sequence (add-on applies)

Per-period payment

$0.00

Enter visits to estimate

When total visits are at or above the threshold, the period is paid as a full case-mix-weighted 30-day period (use the PDGM Calculator for the case-mix-weighted amount). Below the threshold, it is paid per visit at the CY 2026 national rates shown here.

Per-visit amounts are national CY 2026 rates before wage-index adjustment; actual payment is wage-adjusted by CBSA.