RCS Therapy Categories

If you've followed the RCS proposal at all, you're probably aware that each part A patient will get multiple RUGs. PT & OT share a RUG and speech has a different RUG. That does not mean that those RUGs are not related however.

The speech and PT/OT RUGs are designed that the CMI can be high for only one of the two at a time. (See table below) The acute neurologic category is special. It effects both PT/OT and SLP. When the acute neurologic condition is present, it causes PT/OT CMI to fall and speech CMI to rise.

Keep that in mind when you start seeing rates for PT/OT and speech. You aren't going to be getting high reimbursement for both types of therapy at once.


Some notes on this visualization: The size of the circles represents the number of DRG codes that map to the categories. It DOES NOT mean those are the most common or even likely DRG codes. Also notice the category "Other Orthopedic is missing. Currently there are no DRG codes that map to this category. (As of 5-17-2017 that is.)