APR-DRG

The South Carolina Department of Health and Human Services (SCDHHS) intends to move to a new method of paying for hospital inpatient services. The new method will be based on All Patient Refined Diagnosis Related Groups (APR-DRGs). Our goals are to implement a new payment method that is sustainable and more appropriate to Medicaid using a modern DRG algorithm, that enables reduced payment for hospital-acquired conditions, and that simplifies the current payment method where appropriate.

This document provides questions and answers about the new method. We invite additional questions and we welcome suggestions.

SC APR DRG Calculator  v32
Please remember that for pricing purposes, the hospital specific per discharge rates of teaching hospitals include the Graduate Medical Education components (Direct and Indirect Medical Education if applicable).

SC APR DRG Calculator  v28

 

Please note that changes remain possible before the implementation date.

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