Variable Per Diem (VPD) Adjustment

120.3 - Variable Per Diem (VPD) Adjustment (Rev.4409, Issued: 10-04-19, Effective: 11-05-19, Implementation: 11-05-19) The Social Security Act requires that Medicare Part A-covered SNF stays be paid on a per-diem basis. PDPM SNF PPS per diem payments will be reduced according to a prescribed schedule, referred to as the VPD adjustment. Specifically, the PDPM provides for an adjustment factor that is applied to certain components and changes the per diem rate over the course of the stay. Thus, under PDPM, the per diem rate for a given day of the SNF PPS stay may be different from the prior day, depending on an adjustment factor that may be applied against the SNF PPS rate connected with the HIPPS code. Moreover, the VPD schedule applies only to the PT, OT, and NTA components of the per diem rate, with different schedules for the PT/OT components than for the NTA component. A similar adjustment exists under the Inpatient Psychiatric Facility (IPF) PPS. For the PT, OT, and NTA components, the case-mix adjusted per diem rate is multiplied against the variable per diem adjustment factor, following a schedule of adjustments for each day of the patient’s stay VPD Adjustment Schedules PT & OT Components Day in Stay Adjustment Factor Day in Stay Adjustment Factor 1-20 1.00 63-69 0.86 21-27 0.98 70-76 0.84 28-34 0.96 77-83 0.82 35-41 0.94 84-90 0.80 42-48 0.92 91-97 0.78 49-55 0.90 98-100 0.76 56-62 0.88 NTA Component Day in Stay Adjustment Factor 1-3 3.00 4-100 1.00