Our new PDGM grouper allows you to project Health Insurance Prospective Payment System (HIPPS) codes for expected revenue. Now you can easily project a HIPPS code based on the data at the beginning of the billing period, allowing for faster RAP submissions.

The dollar amounts will be calculated based on the patient’s zip code. There is an indicator warning when that particular HIPPS code results in a LUPA based on the number of visits entered.

Developed in partnership with SimpleLTC and modeled after the interactive CMS grouper, our PDGM grouper uses claims data and clinical information to determine a HIPPS code. It’s a robust tool for pre-determining your HIPPS code for the RAP and using projected finances for planning care.

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Est. Reimbursement
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Assessment Date


Number of Visits



Primary DX


Functional Score


You can email these results to yourself once you’ve populated enough data to generate a HIPPS code.

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