This plan amendment updates Diagnosis Related Group (DRG) reimbursement rates for hospital inpatient services, specifying calculation of 2024–25 base rates using claims data from the calendar year ending 18 months prior to the rate effective date; updates the amount of DRG per-discharge add-on payment and year for Children's hospital per-discharge add-on payments; adds a service adjustor for services categorized as Obstetrics or Normal Newborn to the three types of policy adjustors built into the DRG-based payment method; and adds an end date to the methodology for certain existing graduate medical education (GME) payments.
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File 1 - Approval Document Media