The Patient Driven Payment Model (PDPM) -
Information and Resources for Provider Partners

PDPM begins October 1, 2019 and represents the largest change to the Skilled Nursing Facility (SNF) Prospective Payment System since its inception. The information and resources on this page are designed to help our provider partners understand the changes that will occur as the result of moving away from RUG-IV.

Scroll down for information and resources to get you started


We’ve pulled together the most important and relevant documentation to make things as easy as possible for you and your team.

Presentation: Partnering for Success in the Patient Driven Payment Model (PDPM)

Clinical Documentation Submission Requirements - SNF

CMS Facts Sheet, FAQs and Training

Fax Cover Sheet (SNF)

Frequently Asked Questions for SNFs

HIPPS Coding Crosswalk

HIPPS Coding Provider Education

Minimum Data Set (MDS) Overview for Providers

Request for Reassessment of CMG Level Form

White Paper: Can Value-Based Rehabilitation in Skilled Nursing be Achieved with PDPM?

White Paper: Value-Based Therapy and PDPM: Is It Possible?

naviHealth Is An Experienced Partner

For health systems and health plans navigating the fundamental shift from fee-for-service to value-based care, naviHealth is the only care transitions company with the post-acute care management expertise, technologies, clinical services, and post-acute provider network to optimize clinical, financial and quality outcomes across the care continuum.

Visit our website to learn more about naviHealth

naviHealth is accredited by NCQA in Utilization Management

Achieving NCQA Utilization Management Accreditation demonstrates that naviHealth has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards.

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