#pdpm-calculator-wrapper h2 { color: #004a99; margin-bottom: 20px; font-size: 24px; border-bottom: 2px solid #004a99; padding-bottom: 10px; }
#pdpm-calculator-wrapper h3 { color: #004a99; margin-top: 25px; }
.calc-section { background: #fff; padding: 20px; border-radius: 6px; box-shadow: 0 2px 4px rgba(0,0,0,0.05); margin-bottom: 20px; }
.input-group { margin-bottom: 15px; }
.input-group label { display: block; font-weight: 600; margin-bottom: 5px; color: #444; }
.input-group select, .input-group input { width: 100%; padding: 10px; border: 1px solid #ccc; border-radius: 4px; box-sizing: border-box; font-size: 16px; }
.calc-button { background-color: #004a99; color: white; padding: 15px 25px; border: none; border-radius: 4px; cursor: pointer; font-size: 18px; font-weight: bold; width: 100%; transition: background 0.3s; }
.calc-button:hover { background-color: #003366; }
#pdpm-results { margin-top: 20px; padding: 20px; background-color: #e7f3ff; border-radius: 6px; display: none; }
.result-row { display: flex; justify-content: space-between; border-bottom: 1px solid #cfe2f3; padding: 8px 0; }
.result-total { font-size: 22px; font-weight: bold; color: #004a99; margin-top: 15px; text-align: right; }
.info-text { font-size: 14px; color: #666; margin-top: 5px; font-style: italic; }
@media (max-width: 600px) { .result-row { flex-direction: column; } }
function calculatePDPM() {
// FY 2022 Base Rates
var baseRates = {
urban: { pt: 60.91, ot: 56.91, slp: 22.68, nursing: 106.63, nta: 80.46, nonCase: 95.52 },
rural: { pt: 69.83, ot: 64.44, slp: 28.87, nursing: 101.48, nta: 76.57, nonCase: 97.28 }
};
var setting = document.getElementById("facilitySetting").value;
var stayDay = parseInt(document.getElementById("stayDay").value) || 1;
// Get PT/OT CMI
var ptOtVal = document.getElementById("ptOtCategory").value.split("|");
var ptCMI = parseFloat(ptOtVal[0]);
var otCMI = parseFloat(ptOtVal[1]);
// Get other CMIs
var slpCMI = parseFloat(document.getElementById("slpCategory").value);
var nursingCMI = parseFloat(document.getElementById("nursingCategory").value);
var ntaCMI = parseFloat(document.getElementById("ntaCategory").value);
var rates = baseRates[setting];
// Variable Per Diem Multipliers
var ptOtMultiplier = 1.0;
if (stayDay > 20) {
var periods = Math.floor((stayDay – 21) / 7) + 1;
ptOtMultiplier = Math.max(0.1, 1.0 – (periods * 0.02));
}
var ntaMultiplier = 1.0;
if (stayDay <= 3) {
ntaMultiplier = 3.0;
}
// Calculations
var ptFinal = rates.pt * ptCMI * ptOtMultiplier;
var otFinal = rates.ot * otCMI * ptOtMultiplier;
var slpFinal = rates.slp * slpCMI;
var nursingFinal = rates.nursing * nursingCMI;
var ntaFinal = rates.nta * ntaCMI * ntaMultiplier;
var nonCaseFinal = rates.nonCase;
var totalDaily = ptFinal + otFinal + slpFinal + nursingFinal + ntaFinal + nonCaseFinal;
// Display Results
document.getElementById("resPT").innerText = "$" + ptFinal.toFixed(2);
document.getElementById("resOT").innerText = "$" + otFinal.toFixed(2);
document.getElementById("resSLP").innerText = "$" + slpFinal.toFixed(2);
document.getElementById("resNursing").innerText = "$" + nursingFinal.toFixed(2);
document.getElementById("resNTA").innerText = "$" + ntaFinal.toFixed(2);
document.getElementById("resNonCase").innerText = "$" + nonCaseFinal.toFixed(2);
document.getElementById("resTotal").innerText = "$" + totalDaily.toFixed(2);
document.getElementById("pdpm-results").style.display = "block";
}
PDPM Rate Calculator (FY 2022)
Urban (Federal)
Rural (Federal)
NTA is tripled on days 1-3. PT/OT rates decrease after day 20.
Major Joint Replacement or Spinal Surgery (TA)
Non-Surgical Orthopedic/Musculoskeletal (TB)
Orthopedic Surgery (TC)
Acute Neurologic (TD)
Non-Orthopedic Surgery (TE)
Medical Management (TF)
Format: PT CMI | OT CMI
SA (None/None)
SC (Both/None or None/Both)
SH (Both/Both + Mechanically Altered Diet)
SL (Both/Both + Swallowing Disorder + Diet)
SLP-L (All Comorbidities)
ES3 (Extensive Services – Level 3)
ES1 (Extensive Services – Level 1)
HDE2 (High Clinical – Level 2)
HDE1 (High Clinical – Level 1)
LDE2 (Low Care – Level 2)
LDE1 (Low Care – Level 1)
PA1 (Behavioral Symptoms)
NA (12+ points)
NB (9-11 points)
NC (6-8 points)
ND (3-5 points)
NE (1-2 points)
NF (0 points)
Estimated Reimbursement Results
PT Component: $0.00
OT Component: $0.00
SLP Component: $0.00
Nursing Component: $0.00
NTA Component: $0.00
Non-Case-Mix: $0.00
Total Daily Rate: $0.00
Understanding the 2022 PDPM Rate Calculation
The Patient-Driven Payment Model (PDPM), implemented by the Centers for Medicare & Medicaid Services (CMS), represents a significant shift in how Skilled Nursing Facilities (SNFs) are reimbursed. For Fiscal Year 2022, the model continues to focus on clinical characteristics rather than the volume of therapy services provided.
The Five Case-Mix Components
Your daily reimbursement rate is the sum of five distinct case-mix adjusted components, plus a non-case-mix base rate. Each component is determined by specific Patient Assessment Instrument (MDS) data:
- Physical Therapy (PT): Driven by clinical category and functional status.
- Occupational Therapy (OT): Driven by clinical category and functional status.
- Speech-Language Pathology (SLP): Determined by clinical category, presence of swallowing disorders, mechanically altered diets, and cognitive impairment.
- Nursing: Based on the traditional RUG-IV logic but refined for PDPM, focusing on clinical complexity and extensive services.
- Non-Therapy Ancillary (NTA): Captures the cost of high-complexity drugs and medical supplies based on a point-weighted system for comorbidities like HIV/AIDS, Parenteral Feeding, or IV Medications.
2022 Federal Base Rates
For the fiscal year 2022 (October 1, 2021 – September 30, 2022), the unadjusted federal base rates were:
| Component | Urban Base | Rural Base |
|---|---|---|
| PT | $60.91 | $69.83 |
| OT | $56.91 | $64.44 |
| SLP | $22.68 | $28.87 |
| Nursing | $106.63 | $101.48 |
| NTA | $80.46 | $76.57 |
| Non-Case-Mix | $95.52 | $97.28 |
Variable Per Diem (VPD) Adjustments
PDPM accounts for the fact that costs are higher at the start of a stay. The NTA component is multiplied by 3.0 for the first three days of the stay. For the PT and OT components, the rate remains at 100% for the first 20 days and then declines by 2% every seven days thereafter (the "adjustment factor").
Example Calculation
Imagine an urban patient on Day 2 of their stay with a "Major Joint Replacement" clinical category (PT CMI 1.53, OT CMI 1.49) and a High Comorbidity NTA score (CMI 3.24). The calculation would look like this:
- PT: $60.91 × 1.53 × 1.0 = $93.19
- NTA: $80.46 × 3.24 × 3.0 (Day 1-3 multiplier) = $782.07
- Nursing/SLP/Non-Case-Mix values are added to reach the full daily rate.