For home health agencies, providing excellent care isn’t just about doing the right thing for patients—it’s also essential for maintaining strong financial performance under Medicare’s evolving reimbursement rules. In today’s landscape, especially under the Patient-Driven Groupings Model (PDGM), the quality and timeliness of therapy services can make or break your agency’s bottom line.
Here’s how therapy staffing impacts reimbursement—and why partnering with Distinctive Therapy Services (DTS) helps you stay ahead.
1. PDGM Shifts the Focus from Volume to Value
Under PDGM, agencies are no longer reimbursed based on the number of therapy visits provided. Instead, reimbursement is tied to clinical characteristics, functional impairment levels, comorbidities, and timing. While visit volume matters less, the impact of therapy on functional improvement and documentation quality is more important than ever.
Why it matters: Skilled, well-trained therapists can complete accurate functional assessments and document meaningful progress—both of which drive higher reimbursement potential.
2. Timely OASIS and Documentation Directly Affect Payments
Medicare payments depend on the accurate and timely submission of OASIS assessments and plan of care documentation. Delays or inconsistencies can lead to denied claims, payment delays, or lower case-mix scores.
At DTS, our therapists are trained to complete documentation within regulatory timeframes and aligned with PDGM guidelines. That means fewer delays, fewer denials, and a more stable cash flow for your agency.
3. Therapist Expertise Boosts Functional Scoring Accuracy
Functional scoring in OASIS (GG items) plays a key role in determining reimbursement. Therapists who understand how to assess and document these items properly help ensure that your agency receives credit for the true clinical complexity of the patient.
We work with clinicians who are skilled in functional scoring and committed to accurate, defensible documentation—so your patients receive the care they need, and your agency receives the reimbursement it deserves.
4. Missed Visits & Incomplete Care Plans Can Undermine Revenue
When therapy visits are missed or delayed, care plans can become incomplete—putting your agency at risk for compliance issues, unsatisfied patients, or poor outcomes. That, in turn, can negatively impact star ratings and value-based purchasing metrics.
By partnering with DTS, you gain access to reliable, credentialed therapists who show up on time, deliver excellent care, and keep the care plan on track—supporting both patient outcomes and your financial stability.
5. Audit-Ready Support for an Evolving Regulatory Environment
CMS audits are increasing, and agencies are under pressure to demonstrate clinical necessity, correct documentation, and proper billing. Working with a partner like DTS gives you the peace of mind that your therapy documentation will stand up to scrutiny.
We help agencies stay compliant, consistent, and confident in their documentation processes.
Partner With DTS for Clinical and Financial Success
At Distinctive Therapy Services, we’re more than just a staffing solution—we’re your partner in delivering better outcomes, maintaining compliance, and optimizing revenue in a complex Medicare environment.
📞 Ready to strengthen your therapy team and your PDGM strategy? Let’s talk.