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PDPM LTC Algorithm Update for K0520A2

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The Texas Health and Human Services Commission (HHSC) has identified a field that was mistakenly omitted from the Patient Driven Payment Model for Long-Term Care (PDPM LTC) nursing component calculation.

The K0520A2: Nutritional Approaches – Parenteral/IV Feeding – While Not a Resident field was not included in the nursing component’s Special Care High evaluation. HHSC is updating the PDPM LTC algorithm to correct this issue.

After HHSC updates the algorithm, the content of the K0520A2 field will be included in the evaluation when the following two conditions are met:

  • The content of the A1700: Type of Entry field is “1. Admission” or “2. Reentry.”
  • The date in the A2300: Assessment Reference Date field is within seven days of the date in the A1600: Entry Date field.

Note: This change applies only to the PDPM LTC calculation on the nursing facility (NF) Minimum Data Set (MDS). NF waiver assessments are not impacted.

HHSC is prioritizing this update and expects to deploy the corrected algorithm in December 2025.

No action is required for NFs at this time. NFs should continue submitting MDS assessments and claims as usual. Impacted assessments and claims will be retroactively adjusted.

Additional details about the deployment timeline will be provided soon.

For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) LTC Help Desk at 800-626-4117.