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Updated PDPM LTC Algorithm Deployed

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As previously announced, the Texas Medicaid & Healthcare Partnership (TMHP) deployed the updated Patient Driven Payment Model for Long-Term Care (PDPM LTC) algorithm on September 26, 2025.

Effective September 27, 2025, the updated PDPM LTC algorithm applies to the following assessments that were submitted through the Long-Term Care Online Portal (LTCOP):

  • Minimum Data Set (MDS)
  • Medical Necessity and Level of Care (MN/LOC)
  • STAR Kids Screening and Assessment Instrument (SK-SAI)

PDPM LTC Value Corrections

The Texas Health and Human Services Commission (HHSC) will continue working with TMHP to update existing MDS, MN/LOC, and SK-SAI assessments that display incorrect PDPM LTC values.

Assessments that currently show a nursing component score of “P” with a nursing function score of “0” through “5” will be reassigned a nursing component score of “B.”

Note: These component scores are explained in the previous article.

TMHP will publish a follow-up notification after they have corrected all affected assessments and updated related systems. Providers do not need to take any action or call the TMHP LTC Help Desk at this time.