Medicare Advantage, Part D, Medicaid

CMS Home Health PDGM Case-Mix Weights

medicare_silver.fact_hh_pdgm_weight·live·silver·Medicare Home Health PDGM Weights

Rows

432

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1CMS Home Health Patient-Driven Groupings Model (PDGM) case-mix table — per HIPPS code (432): clinical group + admission source/timing + comorbidity adjustment, the recalibrated case-mix WEIGHT, and the LUPA visit threshold.
2Sourced from the CMS Home Health PPS Case-Mix Weights zip (clean XLSX) and anchor-VALIDATED (HIPPS 1FC11 = 1.0804).
3Reprices HH 30-day periods for the 23k+ HHAs we roster (dim_hha): payment ~= 30-day base rate x recalibrated_weight x wage index.
4CY2026 live.
5Third full non-acute repricer.

Grain

Key	Grain
N/A	1One row per (calendar_year, HIPPS) — recalibrated PDGM case-mix weight + LUPA threshold.

Columns (22)

Column	Type	Meaning
`calendar_year`	int
`hipps`	string
`clinical_group_timing`	string
`admission_source_timing`	string
`comorbidity_adjustment`	string
`recalibrated_weight`	double
`lupa_threshold`	double
`observed_period`	date
`asserted_at`	date
`effective_period_start`	date
`effective_period_end`	date
`cms_vintage_sequence`	int
`parse_revision`	int
`parser_artifact_hash`	string
`source_url`	string
`sha256_content_hash`	string
`source_id`	string
`is_current`	boolean
`bronze_object_key`	string
`s3_version_id`	string
`vintage_tag`	string
`drug_source_version_id`	string

Query it

describe_data_source(source_fqn="medicare_silver.fact_hh_pdgm_weight")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_hh_pdgm_weight WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`hipps`
Join	`how_to_join(source_fqn="medicare_silver.fact_hh_pdgm_weight")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_hh_pdgm_weight
Note	Iceberg medicare_silver.fact_hh_pdgm_weight, partition by calendar_year, replace. Source = CMS HH PPS Case-Mix Weights annual zip.

This page as markdown: /docs-md/data/medicare_silver_fact_hh_pdgm_weight.md · every page in one file: /llms-full.txt