Rug Iv Classification System 66 Group

The aim of the rug refinement is to improve the ability of the existing rug iii classification system to explain non therapy ancillary nta costs.

Rug iv classification system 66 group.

These codes are effective as of october 1 2020. Use the hierarchical classification worksheet in chapter 6 of the rai manual. Guide to manually determine the appropriate rug iv classification based on the responses from the mds assessment. The purpose of this rug iv version 1 00 calculation worksheet for the 66 group model is to provide a step by step walk through to manually determine the appropriate rug iv classification based on the data from an mds assessment.

Scope in the rug iv 48 group model compared to the rug iv 66 medicare group model the rehabilitation. Pdpm is a case mix group cmg reimbursement method that focuses on clinically relevant factors rather than volume. Prospective payment system and consolidated billing for skilled nursing facilities. Logic version 1 03 and code version 1 03 0 july 18 2013 rca rug classification.

Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies. Rug assignments weights are applied at the individual level but the average relative risk of a facility s residents is typically used to adjust the nursing components of state medicaid payment systems one exception. Code regardless of resident s self performance classification level of support definition. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions.

The urban institute re examined prior efforts by abt associates 2000 and dr. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. Mds 3 0 rug iv 66 category table urban adls end splits rug cmi rate 042 aids 11 16 not used rux 66 737 08 1 680 54 2 10 not used rul 65 721 01 1 643 90 11 16 not used rvx 63 656 06 1 495 82 2 10 not used rvl 61 588 60 1 342 01. This method is stemming from the snf pps fy2012 final rule and was previously rug iii.

Rug iv categories and characteristics 1 major rug iv. Texas medicaid adjusts the rug 34 relative risk weights to reflect local practice to establish person level payments. Updates to the value based. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 rug iv grouper overview.

Brant fries 2003 using data from our 2001 analysis files and replicated and validated the research.