DRG rate definition

DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse hospitals for routine and ancillary costs of providing care for an inpatient stay.
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DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse
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DRG rate means the all inclusive dollar amount applied to the appropriate DRG Weight which results in the Anthem Rate, if the reimbursement methodology as set forth in the PCS is on a DRG basis.
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Examples of DRG rate in a sentence

  • Certain DRGs are established to specifically include only transfer cases; for these DRGs, reimbursement shall be equal to the DRG rate.

  • The per diem rate is determined by dividing the appropriate DRG rate by the geometric mean LOS for the specific DRG to which the case is assigned.

  • In such instances, policy requires that each hospital’s payment will be the lesser of the DRG rate or a rate calculated by the cost-to-charge ratio (CCR).

  • For example, the PSI Software reports the low-mortality DRG rate for all the included DRGs and separately by DRG type: adult medical, adult surgical (with and without an operating room procedure), pediatric medical, pediatric surgical (with and without an operating room procedure), and obstetric and psychiatric.

  • House Bill 71, Second Extraordinary Session of 2009, requires that the Mississippi Division of Medicaid develop and publish a set of reimbursement rates that are at least equal to those allowed under Medicare for the identical or closely related Medicare Diagnosis Related Groups (DRG) rate.

  • The equivalency factor is a factor used to hold the hospital's specific state administered program DRG conver- sion factor or rates at the same level before and after the med- icaid DRG rate is rebased.

  • Each relative weight is multiplied by the base amount to determine the DRG rate.

  • Contractors are required to pay HAF hospitals at the enhanced Medicaid rates for HAF eligible services detailed below:  HAF eligible hospitals  Contracted providers: MCEs shall pay 100% of the enhanced (HAF) rates, which is 100% of the fee schedule rate multiplied by the HAF factor OR 100% of the Inpatient APR DRG rate multiplied by the HAF factor.

  • Cases falling into DRGs 456, 639, or 640 shall not be treated as transfer cases, but the full DRG rate shall be paid to the transferring hospital.

  • The adjustments may be the result of duplicative processing of a claim, payment of a claim at the wrong Diagnostic Related Group (DRG) rate, a request from a provider, or for any reason an contractor adjusts a claim payment.


More Definitions of DRG rate

DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse hospitals for routine and ancillary costs
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Related to DRG rate

  • LIBOR Rate means a rate per annum (rounded upwards, if necessary, to the next higher 1/100th of 1%) determined by the Administrative Agent pursuant to the following formula: LIBOR Rate = LIBOR

  • Base Rate means, for any period, a fluctuating interest rate per annum as shall be in effect from time to time which rate per annum shall at all times be equal to the highest of:

  • Reference Rate means the rate specified as such hereon.