Pdgm Comorbidity Adjustment Table, Most agencies leave 3–6% of revenue on the table here. Clinical grouping (twelve subgroups): musculoskeletal rehabilitation; neuro/strokerehabilitation; wounds; Medication Management, Teaching, and Assessment (MMTA) Functional impairment level (three subgroups): low, medium, or high. 3. Learn more about the comorbidity adjustment category of the PDGM and how it applies to your home health agency. Admission source (two subgroups): community or institutional admission source. Checking the updated subgroup tables will help identify which diagnoses trigger low adjustments and which combinations qualify for high comorbidity adjustments. . Source: 2020 proposed payment rule Dec 2, 2025 · CMS issued a final rule [CMS-1828-F] that finalizes routine updates to the Medicare home health payment rates; finalizes permanent and temporary behavior adjustments and recalibrates the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. Weights are determined by first calculating the predicted resource use for a particular combination of admission source, episode ti functional impairment level, and comorbidity adjustment. There are two levels: No Comorbidity Adjustment: No significant secondary conditions identified. kwcvu4, fx, qek, 2mgtpoe, awm, hgcc, 5d, kdrx, y2, 2bouh,