Events Careers Client Login

PDGM Resources

Every detail in PDGM impacts your bottom line. From diagnosis codes to comorbidity adjustments, these tools and resources give your team the clarity needed to optimize payment and reduce risk across every period of care.

Maximize Your Revenue Under PDGM

Structure of the Patient-Driven Groupings Model

Understand exactly how patient data flows through the PDGM formula — from admission source to clinical grouping to functional impairment — and how each factor determines your final payment group.

See The Formula

PDGM ICD Lookup Tool

Ensure your primary diagnosis code is valid. There are over 43,000+ primary Dx codes — but only those on CMS’s approved list will be accepted. Use this tool to confirm your primary diagnosis is billable.

See The Tool

PDGM Comorbidity Adjustment Tool

Check for comorbidity codes that may increase payment. Secondary diagnosis codes can affect your plan of care and potentially increase payment by up to 20%. Use this tool to see if your comorbidity qualifies for an adjustment.

See The Tool

PDGM LUPA Lookup Tool

Avoid unnecessary payment reductions. Determine the visit threshold for your 30-day period of care. This tool helps you avoid a LUPA adjustment when more visits are clinically appropriate.

See The Tool

Request A Consultation

Navigating PDGM doesn't have to be complicated. SimiTree's experts are here to help you validate codes, maximize reimbursements, and stay ahead of every adjustment. Fill out the form below and a member of our team will be in touch to walk you through how we can support your organization.