CHA News Article

Medi-Cal APR-DRG Methodology Begins July 1

Following approval by the Centers for Medicare & Medicaid Services in May allowing the implementation of the All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement methodology, hospitals will need to finalize their preparation for the July 1 start of the new payment system. The California Department of Health Care Services (DHCS) has updated its DRG web page at www.dhcs.ca.gov/provgovpart/Pages/DRG.aspx with current information and bulletins including:

  • APR-DRG Reimbursement Implementation Official Notification
  • Most Common Denials Anticipated Under DRGs
  • New Medi-Cal Provider Manual pages for DRG billing instructions

In addition, DHCS will continue its APR-DRG monthly training series through September. Any questions related to DRG reimbursement, as well as requests to be added or removed from the DRG listserve, can be sent directly to DRG@dhcs.ca.gov.

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