FY 2011 RUG-IV Education & Training

Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Resource Utilization Group-Version 4 (RUG-IV) 

National Provider Call with Question & Answer Session -- November 9, 2010

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group hosted a national provider conference call on the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Resource Utilization Group-Version 4 (RUG-IV). This toll-free call took place on Tuesday, November 9, 2010.

This call was one in a series of calls designed to provide information on key aspects of the RUG-IV SNF PPS case mix system, which was put into place on an interim basis effective October 1, 2010.  CMS held three previous calls, which provided details of significant changes related to the RUG-IV payment system.

For this call, CMS subject matter experts reviewed some of the significant changes associated with the RUG-IV payment system.

A PowerPoint slide presentation for the call is available in the "Downloads" section below.

For those who were unable to attend, a transcript of the call and MP3 audio file is available in the Downloads and Related Links Inside CMS sections below.

Previous National Provider Calls

The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group hosted three national provider conference calls on the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Resource Utilization Group-Version 4 (RUG-IV).

These calls were designed to provide information on key aspects of the RUG-IV SNF PPS case mix system put into place on an interim basis effective October 1, 2010.

June 23, 2010 Call

CMS discussed coding procedures with an emphasis on:

• the appropriate “Look-back Period” to be used when coding the Minimum Data Set (MDS) 3.0,
• the reporting of individual, concurrent, and group therapy for accurate payment, and
• the changes to the coding requirements for ADLs, including their impact on the assignment of MDS 3.0 records to a RUG-IV group.

An updated PowerPoint slide presentation with a list of changes, MP3 audio file, and transcript are available for download from the Downloads and Related Links Inside CMS sections below.  In addition, each PowerPoint slide that has been revised is labeled in the header with a subscript ‘revised'.

August 24, 2010 Call

CMS held a second call where subject matter experts discussed the transition from RUG-III to RUG-IV. The updated PowerPoint slide presentation with a list of changes, MP3 audio file, and transcript are available for download from the Downloads and Related Links Inside CMS sections below.  In addition, each PowerPoint slide that has been revised is labeled in the header with a subscript ‘revised'.

September 1, 2010 Call

The third call discussed several SNF PPS policies including Start of Therapy and End of Therapy Other Medicare Required Assessments and the SNF short stay policy. The updated PowerPoint slide presentation with a list of changes and MP3 audio file are available for download from the Downloads and Related Links Inside CMS sections below.  The transcript is forthcoming. In addition, each PowerPoint slide that has been revised is labeled in the header with a subscript ‘revised'.