Encounter Reporting

To assist PACE organizations in increasing the range, breadth and overall volume of encounters to be submitted to the Centers for Medicare & Medicaid Services (CMS), NPA has developed a set of Encounter Reporting coding resources specifically for PACE.

ICD-10

The purpose of the NPA Model ICD-10 Superbill is to facilitate the coding and collection of comprehensive PACE participant diagnoses that are high in prevalence, require the allocation of significant health care resources, and are generally chronic rather than acute in nature.

For more information, contact Charles Fontenot.

Medical Director’s Handbook

The Medical Director’s Handbook is a resource for prospective medical directors of emerging PACE organizations and new medical directors of existing PACE organizations. The handbook outlines the responsibilities of PACE medical directors as defined by PACE Provider Regulations and convention.

For more information, contact Shawn Bloom.

Preventive Care Guidelines and Model Practices

PACE participants are a heterogeneous group, with differing health profiles, prognoses, preferences and care goals. Life expectancy and quality-of-life issues require an individualized context for applying practice guidelines that may have been developed for a population of non-frail adults. The Primary Care Committee developed Preventive Care Guidelines and Model Practices that reflect PACE-derived expertise in applying the evidence about screening, prevention and treatment.

These tools were adapted from evidence-based guidelines for older adults and developed specifically for PACE participants, whose goals of care are divided into three broad categories: promoting longevity, optimizing function, and providing comfort care. The guidelines and model practices are not intended to replace the clinical judgment of providers or establish a standard of care, since the shared decision-making of primary care physicians and participants/caregivers is crucial in the PACE Model of Care.

For more information, contact Shawn Bloom.

There are more than 100 PACE programs in 31 states. See how your demographics and service utilization compare with those of your peers.

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