Did you know that a therapist does not determine a patient RUG level? A RUG level is assigned based on a comprehensive, thorough evaluation and subsequent therapy treatment plan developed by the therapist for the individual patient. The therapy treatment plan should be a clinically driven, collaborative process that identifies the clinical/skilled needs of the patient. The RUG level is determined based on the anticipated treatment time indicated to achieve the goals in the treatment plan. So, who determines the RUG level? The patient, through identification of functional impairments, deficits and overall strengths.