Wondering Where Your State Stands on PDPM Medicaid?
Get a simple, state-by-state snapshot of where PDPM Medicaid transitions stand today. Prepared by Gravity Consulting in partnership with LeadingAge and AAPACN to help providers stay informed.
PDPM Medicaid Experts. Proven Results.
Everything You Need to Know, Clearly Organized, For Free.
This guide is designed to give you clarity at a glance — a FREE state-by-state summary of how Medicaid nursing facility reimbursement is evolving under PDPM.
We’ve distilled key details for every state into a concise reference, saving you time and eliminating confusion. Whether your state has already transitioned, is planning to, or remains on RUGs, it’s all here — clearly organized, easy to navigate, and constantly updated.
This source also contains effective strategies to optimize the accuracy of CMI for nursing only states, nursing + NTA states, and states that include therapy for PDPM Medicaid.
We created this resource because providers deserve a simple way to stay informed and feel prepared as reimbursement models continue to shift.
Guidance Beyond the Guide: Helping You Navigate Medicaid PDPM with Confidence
This guide is just one way Gravity Consulting helps providers navigate PDPM Medicaid transitions.
We help you understand what’s changing and how to keep your documentation, coding, and care delivery aligned — so your organization stays ready.
If you’re looking for more than information — if you’re looking for experienced guidance that helps you boost the accuracy of your CMI under PDPM Medicaid — we’re here and we’ve already helped providers just like you get the results they need.
Start a conversation with us or call us at 844-899-6883.
A Clear Summary of What This Guide Covers
- State-by-state summaries of Medicaid PDPM transitions
- Which states are using which PDPM components (eg. nursing, NTA, PT, OT, ST)
- Confirmed effective dates for each state’s policy changes, and which states are still under RUGs
- Clarity on states planning a transition vs. states with no PDPM plans
- Links to official state documentation for further reading
Struggling with PDPM Medicaid? Let’s Fix That.
Schedule a conversation to understand how PDPM Medicaid is impacting your facility and discover the strategies that can protect your margins.
PDPM Medicaid: What’s Changing and Why It Matters
Did Your CMI Just Drop? Worried about what PDPM Medicaid is going to do to your bottom line?
Under PDPM Medicaid, therapy is no longer the primary driver of Case Mix Index (CMI)—a major shift from prior RUG-III and RUG-IV models.
In legacy systems, the mere presence of therapy services during the look-back period often outweighed most nursing clinical indicators, making therapy the dominant factor influencing CMI. However, with PDPM Medicaid therapy plays a minimal role in reimbursement.
This represents a fundamental change: communities that historically achieved high CMIs through therapy-driven RUGs are now the most vulnerable under PDPM and must adopt new clinical, documentation, and oversight processes to ensure reimbursement accuracy.
While nursing clinical indicators remain central, the diminished role of therapy demands a strategic shift to sustain or improve financial performance under the new model. While it may not be feasible to adopt all strategies simultaneously, facilities are encouraged to assess which approach best aligns with their current workflows, documentation practices, and clinical culture. Begin by selecting one high-impact strategy, implement it with consistency, and build from there as your team becomes more familiar with the PDPM Medicaid framework.
Need help? Click any item below to learn more about how Gravity can help with PDPM Medicaid strategies such as:
- PDPM Medicaid CMI audits and training
- LTC Section GG training and auditing
- PDPM Medicaid morning meeting process consulting
- MDS training for coding accuracy under PDPM Medicaid
- Strategies for coordination with ancillary physician services
- Additional customized strategies based on your state and your facility
In some nursing facilities, these strategies have contributed to daily rate increases of $10 to $50 per resident under PDPM.
Moving Forward Together
At Gravity Consulting, we’re more than a resource — we’re a partner for organizations navigating complex challenges like PDPM Medicaid. We’re here to help you avoid CMI plunges, optimize CMI accuracy, and wrap excellent clinical care into documentation that stands up to scrutiny.
Ready to see how we can help your organization?