Frequently Asked Question of the Month:
LUPA…what is it and why should I care about it?
LUPA = Low Utilization Payment Adjustment. It is a standard per visit payment for episodes of care with a low number of visits. Currently, under PDGM, the LUPA threshold will vary by HHRG score and will be based on the 30 days of care. It is important because it affects how we are reimbursed for patient care. If you do not meet the LUPA threshold, the agency will get reimbursed per visit and not per episode.
Symbria is committed to maintaining a high standard and level of communication with our clients and employees regarding clinical education, PDGM understanding, patient assessment, home health regulations, and coding efficiency. As a result, the Home Health Insider was born. In this monthly offering, we hope to provide some valuable information that can foster a quality level of care that meets the needs of the patients that we serve.