PDGM stands for what in Medicare home health payment models?

• A. Patient-Directed Groupings Model for Medicare reimbursement
• B. Patient-Driven Groupings Model for Medicare reimbursement
• C. Patient-Driven Grouping Model for Medicare reimbursement
• D. Patient-Defined Grouping Model for Medicare reimbursement

Answer: (B)

PDGM stands for Patient-Driven Groupings Model. This Medicare home health payment approach bases reimbursement on patient-specific clinical and functional characteristics and admission factors, using 30-day payment periods. It shifts emphasis away from counting therapy visits and toward who the patient is and what they need, which is why it’s described as patient-driven. The other options don’t fit the official terminology: they use "Directed," "Grouping" in the singular, or "Defined," which are not the correct terms.