Home Health Patient-Driven Groupings Model (PDGM)
The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1689-FC)
that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2019. For more information, please refer to the following resources.
CGS Resources:
- CGS Overview: Home Health Patient-Driven Groupings Model (PDGM)
- Top Provider Questions – Home Health Patient-Driven Groupings Model (PDGM)
- Request for Anticipated Payment (RAP) Changes in Calendar Year 2021 Fact Sheet

- Submitting a Final Claim
Self Service Options:
CMS Resources:
- CMS CY 2020 Home Health Final Rule with Comment Period

- CMS Home Health Patient-Driven Groupings Model Web page

- CMS CY 2020 Interactive Grouper Tool

- CMS CY 2020 PDGM Case Mix Weights and LUPA Thresholds

- August 21, 2019, Home Health Patient-Driven Groupings Model: Operational Issues presentation
- February 12, 2019, Overview of the Patient-Driven Groupings Model (PDGM)
presentation
- MM11577 – Manual Updates Related to Calendar Year (CY) 2020 Home Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring

- SE20005 – The Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM)

- Home Health Agency (HHA) Center

Updated: 01.21.2026

