The Patient-Driven Groupings Model (PDGM) has paid home health since 2020: 30-day payment periods, case-mix based on diagnosis and admission source instead of therapy volume, and — since 2022 — a Notice of Admission (NOA) that replaced the upfront RAP cash. The practical effect is that cash arrives later and depends heavily on accurate coding and filing the NOA on time.
PDGM cut the payment period from 60 days to 30 days and removed therapy-visit thresholds as a payment driver. Case-mix now comes from clinical grouping (primary diagnosis), admission source, timing (early vs. late), functional level, and comorbidities.
Translation: coding and documentation drive revenue far more than visit volume does.
The old RAP gave agencies a meaningful cash advance at the start of care. The Notice of Admission (NOA) that replaced it carries no payment — and if it’s filed late, your payment for that period is reduced for every day it’s late. Revenue is more back-loaded than it used to be.
NavSuccess does this for home care & healthcare agencies — see Cash flow & forecasting.
It changes what drives your payment — clinical grouping and coding, not therapy volume. Two agencies with the same visits can be paid very differently based on documentation.
A Notice of Admission. It replaced the RAP, carries no cash, and must be filed promptly — late filing reduces the period’s payment.
With a period-based (30-day) revenue model and a rolling weekly cash forecast that accounts for claim timing and denials.
Book a free 30-minute consultation. We’ll look at where your books and compliance stand and show you exactly what we’d take off your plate.