Podchaser Logo Rate on Podchaser

Episode 38

full
Published on:

31st Oct 2023

Ep 38: Medicare and Medicaid Policy Updates: RUGS, PDPM, MDS

Medicare and Medicaid Policy Updates: RUGS, PDPM, MDS

Is Medicare No Longer Paying for OT in SNF?

I’ve seen a lot of concern on social media and in my DMs about potential significant changes to PDPM in Skilled Nursing Facilities, specifically around Medicare no longer paying for OT in SNF. You can rest assured that there have NOT been any major changes to Medicare Part A for therapy but other changes have been made. That’s why this week on The Amplify OT Podcast, I am talking about updates to PDPM in Skilled Nursing Facilities (SNF) and when these changes are set to take place.


Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.


The updates I cover in this episode include:

  • CMS finalized that it will no longer support the utilization of RUG payments for Medicaid programs. 
  • There have not been any cuts to Medicare Part A SNF funding but rather a 4% increase. 
  • Removal of Section G (former ADL section), integrating some items into Section GG (function and self-care).
  • The changing of quality measure scores. 
  • Changes and modifications around COVID-19 policies. 
  • ICD 10 Code mapping changes for Parkinson's and COVID-19.


Amplify OT Resources

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!



CLICK HERE to save $101 off Medbridge Today!



CONNECT WITH AMPLIFY OT:


Helpful Links





©Amplify OT

Next Episode All Episodes Previous Episode

Listen for free

Show artwork for The Amplify OT Podcast

About the Podcast

The Amplify OT Podcast
Empowering Occupational Therapy Practitioners to Lead Change in Healthcare
The Amplify OT Podcast is your go-to show for making sense of healthcare policy, advocacy, and reimbursement in occupational therapy. Hosted by Clarice Grote—occupational therapist, founder of Amplify OT, and self-proclaimed policy nerd who actually enjoys reading the long documents most people avoid—this podcast breaks down complex systems so you can navigate them with confidence.

No matter where you are in your occupational therapy journey—student, new grad, educator, or experienced clinician—you belong here as an important part of our OT Amplifier community. Each episode is designed to empower you with the knowledge and tools you need to understand how policy impacts your practice, your patients, and the future of the profession.

The work you do matters. Your voice matters. And advocacy isn’t just possible—it’s powerful. So let’s get started—because change starts here.

About your host

Profile picture for Clarice Grote

Clarice Grote

Clarice Grorte is an occupational therapist and lived the transformation from guessing to confident by learning to understand policy.

She's the creator of The Amplify OT Podcast, Mastering OT Policy & Medicare™, and the Amplify OT Membership™.

She is passionate about spreading the word on the value of occupational therapy and proving to OTs and OTAs that they already have the skills the need to be amazing OT advocates