Estimating PPD Under Proposed RCS
Included in the CMS proposal to scrap RUGS-IV and move to a new system called RCS-1 was a table that showed the estimated percent change in certain RUGs. Using that table and the current 2017 rates, we can (roughly) estimate reimbursement based on current caseload. Keep in mind that this is only an estimate! RCS is bound to change at least some. Also keep in mind that:
- RCS was designed using 2014 data because that's what was available.
- You should probably be using an average of several months to get a better idea. (You don't have to average. Just add several months to the boxes below.)
RUGS-IV | |
RCS-I | |
Difference |
Select RUGs
Rehab + Extensive
|
Rehab
|
Extensive Services
|
Special Care High
|
Special Care Low
|
Clinically Complex
|
Behavioral
|
Reduced Physical Function
|
---|---|---|---|---|---|---|---|
RUX | RUC | ES3 | HE2 | LE2 | CE2 | BB2 | PE2 |
RUL | RUB | ES2 | HE1 | LE1 | CE1 | BB1 | PE1 |
RVX | RUA | ES1 | HD2 | LD2 | CD2 | BA2 | PD2 |
RVL | RVC | HD1 | LD1 | CD1 | BA1 | PD1 | |
RHX | RVB | HC2 | LC2 | CC2 | PC2 | ||
RHL | RVA | HC1 | LC1 | CC1 | PC1 | ||
RMX | RHC | HB2 | LB2 | CB2 | PB2 | ||
RML | RHB | HB1 | LB1 | CB1 | PB1 | ||
RLX | RHA | CA2 | PA2 | ||||
RMC | CA1 | PA1 | |||||
RMB | |||||||
RMA | |||||||
RLB | |||||||
RLA |