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Blog: 2024 Fee Schedule Update: Access Medicare Part A PDPM & Part B Rates with Our PDPM Calculator

On November 16th, CMS published the 2024 Physician Fee Schedule effective January 1st, 2024. For your convenience, we have updated our PDPM Rate Calculator in collaboration with Data IQ to include Medicare Part A PDPM rates as well as the updated 2024 Fee Schedule. Click here to access the revised resource.

Updated Med A PDPM Rate Calculator Tabs

  • Rates specific to the Provider, HIPPS code, and Day of Stay with Wage Index and Value-Based Purchasing (VBP) applied
  • CMI and Base Rates, adjusted for Wage Index and VBP
  • 2023 vs 2024 Base Rate Comparison

NEW: The Medicare Part B tab reflects the applicable Part B Fee Schedule effective January 1st, 2024, for commonly utilized codes for therapies.

Conversion Factor
CMS finalized the Conversion Factor rate of $32.7375, a 3.4% decrease from the CY 2023 rate of $33.8872.

  • 1.25% of the decrease is attributable to the decrease in the statutory adjustment from CY 2023.
  • 2.20% is attributable to policy changes included in the Final Rule, specifically the G2211 complexity code.

PT/ST & OT Threshold for KX Modifier
This will be built into QRM’s NetHealth effective January 1st, 2024.

  • $2,330 PT/ST
  • $2,330 OT

Telehealth for Therapy
In the Final Rule, CMS finalized that therapists who provide therapy services using telehealth in institutional settings have the authority to continue doing so until December 31st, 2024.

New Caregiver Training Code
The new code clarifies that “caregiver” includes adult family members and others actively involved in care provision with coding options available when patients are not involved in the training session.

Additional Federal Register Points of Clarification
Please follow this link for additional details and points of clarification within the November 16th, 2023 Federal Register.

The Point Is: Be sure the updated rates are being shared and utilized with your billing departments. The QRM PDPM Rate Calculator can help the entire IDT view 2024 rates and determine the impact of choosing an optional IPA MDS assessment with changes in condition. Gain insight into how PDPM and Part B impact revenue through appropriate billing and coding. 

We hope this can be a quick one-stop option for you and your appropriate team members.

Please let us know if we can be of help. 

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