Boost your PDPM with physiatry - SpecialtyRx
October 28, 2022
Boost your PDPM with physiatry

Adding physiatrists to your staff can benefit patients and profits

While having a doctor trained in rehab seems like a perfect match for long term care facilities, physiatrists are rarely used and facilities may be missing out. Physiatry care can result in lower hospital readmission rates, improved patient outcomes and greater patient satisfaction.

They can also improve a facility’s bottom line. Physiatrists trained in Patient Driven Payment Model (PDPM) are better equipped to obtain accurate reimbursement. By capturing more accurate codes, facilities can get the payment they are entitled to for nursing and therapy services.

In a recent, independent research study, PDPM daily reimbursement rose from $58 to $72 per patient day across three corporate-owned facilities in multiple states, when physiatrists were part of patient care, with the highest increases in Medicaid Part A residents. Over the course of the study, facilities earned an additional $379,000.

It appears that the physiatrists were able to recognize more appropriate ICD-10 codes that resulted in higher payments. For example, instead of using codes for morbid obesity, which does not increase payment, physiatrists chose codes that more accurately aligned with actual patient need, which resulted in greater payment.

Physiatrists were also better at providing and encouraging skilled documentation that is necessary in the MDS in order to boost payments for selected codes. They were also associated with higher payments for nursing, non-therapy ancillary and speech therapy because of how they completed ICD-10 coding and Section GG.


Adding a Physiatrist to patient care is a great way to improve the quality of care you can provide to your residents, all the while ensuring the proper use of ICD-10 codes resulting in better reimbursements.  At SpecialtyRx we do our part to help you save money and contain costs, while continually looking at other creative ways that you can receive the payments you are entitled to,” stated Saba Ansari, Pharm D – VP of Clinical Services.