Home Health Agencies: Check Out This Free PDGM Grouper Tool!

Lisa Selman-Holman, JD, BSN, RN
President, Selman-Holman & Associates

I’m sharing Lisa’s post so you can take advantage of this free PDGM Grouper Tool as well as the other great information you need for your agency.

Our new PDGM grouper allows you to project Health Insurance Prospective Payment System (HIPPS) codes for expected revenue.  Now you can easily project a HIPPS code based on the data at the beginning of the billing period, allowing for faster RAP submissions.

The dollar amounts will be calculated based on the patient’s zip code.  There is an indicator warning when that particular HIPPS code results in a LUPA based on the number of visits entered.

Developed in partnership with SimpleLTC and modeled after the interactive CMS grouper, our PDGM grouper uses claims data and clinical information to determine a HIPPS code.  It’s a robust tool for pre-determining your HIPPS code for the RAP and using projected finances for planning care.


At the end of the on-demand webinar Operationalizing the RAP 2021, Lisa provides a short demo of the PDGM grouper tool. To the view the free webinar & demo, click here