PDPM margin calculator for SNF admissions.
Rate calculators tell you what a stay pays. This models what it may net: your per-diem against your cost of care over the expected stay. It is one input admissions teams weigh when deciding whether a referral is a fit. A planning estimate with your own inputs, in your browser, no sign-up.
Estimate the margin on one admission
Enter the per-diem you expect for the stay, the expected length of stay, and your cost of care. Defaults are illustrative placeholders, not benchmarks, industry averages, or typical results. Replace them with your own numbers before reading the output. Every output is an estimate, not a guarantee.
Limits of this calculator
It multiplies your assumptions
Reimbursement, stay length, and costs are your inputs. If the referral packet does not support them (diagnoses, therapy needs, med list, payer terms), the estimate is wrong before it starts.
It does not set your rate
PDPM component rates come from the MDS assessment after admission; Medicare Advantage rates come from your contract. The methodology page explains how the classification works.
It cannot read the packet
The expensive surprises live in the referral packet: an unverified payer, a missing authorization, an undocumented high-cost medication. The arithmetic will not catch those. Reading the packet will.
Where AdmitScore fits. AdmitScore™ helps staff find the payer, authorization, documentation, and high-cost medication details in the actual packet. Each item shows the quote and page it came from. AdmitScore does not calculate margin; this calculator is a standalone planning tool. Staff verification remains required. See what a review covers.
Verify the inputs before trusting the margin estimate
A margin estimate is only as good as the packet behind it. Run these checks before you trust the number.
Payer and authorization
Is the payer verified, and does a Medicare Advantage plan require prior authorization for this admission? Medicare Advantage authorization explains what to confirm.
Documentation behind the rate
Do the diagnoses, comorbidities, and functional status in the packet actually support the case-mix classification your rate assumes? PDPM admissions signals lists what to look for.
The medication list
One undocumented specialty medication can consume the estimated margin. High-cost med review covers the check worth running.
Using the calculator
Where do I find my per-diem rate?
For Medicare Part A stays, your MDS classification (via your rate software) determines the PDPM per-diem; for Medicare Advantage, the contract sets the rate. If you only have a HIPPS code, a PDPM rate calculator converts it to component rates.
Does this send my numbers anywhere?
No. The calculator runs entirely in your browser. The numbers you enter are never stored, transmitted, or logged, and it never asks for patient information. It takes dollars and days only. Site analytics are separate and load only if you accept cookies.