Due to the government shutdown, updates to information on this website may be limited or delayed. State Medicaid and Children’s Health Insurance Programs (CHIP) continue to operate. Continue to work with the programs in your state to access coverage. For more information about government operating status, visit OPM.gov.

U.S. flag

An official website of the United States government

If we complete multiple inpatient templates for Diagnosis Related Groups (DRG) and per diem, should

The state should complete one template each for the DRG and per diem UPL calculations and these should be placed in one file. The state should also include a summary worksheet in the same file that shows the UPL gap for each ownership category (state government owned, non-state government owned, and private). States should include all necessary supporting documentation.
Date
Topic
Upper Payment Limit (UPL)
The IPH, OPH and NF Templates
Sub Topic
Templates
Reporting with Multiple Methodologies
FAQ ID
92276
FAQ Page
Upper Payment Limit FAQs
FAQ Question
If we complete multiple inpatient templates for Diagnosis Related Groups (DRG) and per diem, should they be in the same file or separate files? Should there be a summary of all the inpatient Upper Payment Limits (UPLs) showing grand totals?