Hospital reimbursement
This page provides information for hospitals serving Medicaid clients using the Washington State Medicaid Prospective Payment System (PPS fee-for-service).
Rates and program information
- Certified Public Expenditures (CPE)
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Disproportionate Share Hospital (DSH) application
- Application and instructions (updated June 1, 2024)
Medicaid cost report
- Cost report form (updated July 8, 2015)
- Cost report instructions (updated June 27, 2014)
Washington Administrative Code (WAC) information
- Critical Access Hospitals (CAH)
-
Interim rates
- January 1, 2025 - present (updated January 13, 2025)
- January 1, 2024 - December 31, 2024 (updated February 12, 2024)
- January 1, 2023 - December 31, 2023 (updated March 14, 2023)
- See all Critical Access Hospital rates.
Additional information
- HCA standard revenue code to cost center crosswalk (updated August 28, 2014)
- Department of Health - Critical Access Hospitals
- Disproportionate Share Hospital (DSH)
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Payments
Low income DSH
- Low income DSH SFY2025 (published February 5, 2025)
- Low income DSH SFY2024 (published July 9, 2024)
- Low income DSH SFY2023 (published July 12, 2023)
- See all low income DSH payments.
Small rural DSH
- Small rural DSH SFY2025 (published February 5, 2025)
- Small rural DSH SFY2024 (published July 9, 2024)
- Small rural DSH SFY2023 (published July 12, 2023)
- See all small rural DSH payments.
Application and instructions (non-CPE)
- DSH application (updated July 1, 2024)
- DSH application troubleshooting (published July 1, 2012)
- Hospital Safety Net Program
-
Fee-for-service (FFS) payments
- CY 2024 4th quarter (published December 20, 2024)
- CY 2024 3rd quarter (published October 28, 2024)
- CY 2024 2nd quarter (published July 16, 2024)
- See All Hospital Safety Net FFS payments
Critical Access Hospital (CAH) grant payments
- SFY2024 (updated July 2, 2024)
- SFY2023 (updated July 2, 2024)
- SFY2022 (updated July 2, 2024)
- See All Hospital Safety Net CAH grant payments
Distressed Hospital Grant
- CY2025 Distressed Grant Application (published April 11, 2025)
- CY2024 Distressed Grant Application (updated February 27, 2024)
Managed Care State Directed Payments
- CY2024 4th quarter (published November 27, 2024)
- CY2024 3rd quarter (published September 13, 2024)
- CY2024 2nd quarter (published August 28, 2024)
- CY2024 1st quarter (published July 16, 2024)
Designated Public Hospital (DPH) Inpatient Directed Payments
- CY2025 1st quarter (published May 9, 2025)
- CY2024 4th quarter (published March 27, 2025)
- CY2024 3rd quarter (published October 28, 2024)
- CY2024 2nd quarter (published July 16, 2024)
- CY2024 1st quarter (published July 16, 2024)
Designated Public Hospital (DPH) Outpatient Directed Payments
- CY2025 1st quarter (published May 9, 2025)
- CY2024 4th quarter (published March 27, 2025)
- CY2024 3rd quarter (published October 28, 2024)
- CY2024 2nd quarter (published July 16, 2024)
- CY2024 1st quarter (published July 16, 2024)
Revised Code of Washington (RCW) information
- Inpatient Prospective Payment System (IPPS)
-
Inpatient provider rates
- May 1, 2025 - present (updated May 1, 2025)
- February 1, 2025 - April 30, 2025 (updated March 4 , 2025)
- November 1, 2024 - January 31, 2025 (updated March 4, 2025)
- See all inpatient provider rates.
Diagnosis-related group (DRG) calculator
- May 1, 2025 DRG Calculator (published May 1, 2025)
- February 1, 2025 DRG Calculator (updated March 4, 2025)
- November 1, 2024 DRG Calculator (updated March 4, 2025)
- See all DRG calculators.
Diagnosis-related group (DRG) grouper weights and utilization/length of stay information
- July 1, 2022 - current (published June 2, 2022)
- April 1, 2018 - June 30, 2022 (updated May 15, 2018)
Outlier factors
- July 1, 2014 - current (published July 2, 2014)
Quality Incentive Payments (QIP) hospital scores
- July 1, 2024 - present (updated July 1, 2024)
- July 1, 2023 - June 30, 2024 (updated July 5, 2023)
- July 1, 2022 - June 30, 2023 (published June 9, 2022)
- View all Quality Incentive Payments (QIP) hospital scores
Additional information
- Outpatient Prospective Payment System (OPPS)
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Provider conversion factors
- April 1, 2025 - present (updated April 1, 2025)
- January 1, 2025 - March 31, 2025 (published December 31, 2024)
- October 1, 2024 -December 31, 2024 (updated December 16, 2024)
- See all provider conversion factors.
EAPG Calculator
- April 2025 EAPG Calculator (published April 1, 2025)
- January 2025 EAPG Calculator (published December 31, 2024)
- October 2024 EAPG Calculator (published October 1, 2024)
- See all EAPG calculators.
Relative weights
- July 1, 2022 - current (published June 2, 2022)
- April 1, 2017 - June 30, 2022 (updated March 17, 2017)
- July 1, 2014 - March 31, 2017 (updated June 26, 2014)
Additional information
- Trauma Program
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Payments
- SFY2025 2nd distribution Level 2-3 hospitals (published April 3, 2025)
- SFY2025 2nd distribution Graduate Medical Education - Trauma hospitals (published April 3, 2025)
- SFY2025 1st distribution Level 2-3 hospitals (published January 3, 2025)
- See all trauma payments.
Additional information