The Non-Therapy Ancillary (NTA) component drives a large share of PDPM revenue variance. Each of the 50 NTA conditions or services carries a point value from 1 to 8; total points map to one of six NTA case-mix groups. One missed condition can cost $40–$80 per patient day.
How the NTA point system works
CMS assigns each qualifying condition or service a point value. Your total NTA score determines the case-mix index (CMI), and a variable per-diem adjustment applies a 3x multiplier for days 1–3 — making early capture critical.
The full 50-item list
| Points | Condition / service | Documentation source |
|---|---|---|
| 8 | HIV/AIDS | Active diagnosis on hospital discharge or PCP note |
| 7 | Parenteral/IV feeding (high intensity) | MAR + intake/output |
| 5 | IV medications | MAR (Section O on MDS) |
| 4 | Tracheostomy care | Care plan + nursing assessment |
| 3 | Multiple sclerosis | Active diagnosis |
| 2 | Diabetic foot ulcer | Wound nursing note + Section M |
| 1 | Asthma / COPD / chronic lung | Active diagnosis + meds |
Where MDS teams lose points
- Lookback window confusion — most NTA items use a 7-day lookback at ARD.
- Active diagnosis rule — the condition must be documented by a physician in the last 60 days AND be a direct relationship to current care.
- MAR-only evidence — IV meds need both Section O coding and a supporting MAR entry.