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)

Disproportionate Share Hospital (DSH) application

Application and instructions (updated June 3, 2023)

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, 2023 - present (updated March 14, 2023)
January 1, 2022 - December 31, 2022 (updated January 25, 2022)
January 1, 2021 - December 31, 2021 (updated January 26, 2021)
January 1, 2020 - December 31, 2020 (updated February 21, 2020)
January 1, 2019 - December 31, 2019 (updated February 4, 2019)
January 1, 2018 - December 31, 2018 (updated March 5, 2018)
January 1, 2017 - December 31, 2017 (published December 28, 2016)
January 1, 2016 - December 31, 2016 (updated June 10, 2016)
January 1, 2015 - December 31, 2015 (updated March 5, 2015)

Additional information

HCA standard revenue code to cost center crosswalk (updated August 28, 2014)
Department of Health - Critical Access Hospitals

Disproportionate Share Hospital (DSH)

Payments

Low income DSH SFY2023 (published July 12, 2023)
Low income DSH SFY2022 (updated May 5, 2022)
Low income DSH SFY2021 (updated June 30, 2021)
Low income DSH SFY2020 (updated May 11, 2020)
Small rural DSH SFY2023 (published July 12, 2023)
Small rural DSH SFY2022 (updated March 1, 2022)
Small rural DSH SFY2021 (updated March 1, 2022)
Small rural DSH SFY2020 (updated March 1, 2022)

Application and instructions (non-CPE)

DSH application (updated June 2, 2023)
DSH application troubleshooting (published July 1, 2012)

Reporting data file (DRDF)

DRDF filing schedule (published July 10, 2014)
DRDF preparation instructions (published July 1, 2012)
DRDF certification review process (updated June 11, 2015)

Hospital Safety Net Assessment (HSNA)

Fee-for-service (FFS) payments

SFY 2023 4th quarter (published June 5, 2023)
SFY 2023 3rd quarter (published April 10, 2023)
SFY 2023 2nd quarter (published January 3, 2023)
SFY 2023 1st quarter (published October 3, 2022)
SFY 2022 4th quarter (published June 21, 2022)
SFY 2022 3rd quarter (published March 22, 2022)
SFY 2022 2nd quarter (published January 18, 2022)
SFY 2022 1st quarter (published September 27, 2021)
SFY2021 4th quarter (published June 8, 2021)
SFY2021 3rd quarter (published March 18, 2021)
SFY2021 2nd quarter (published December 14, 2020)
SFY2021 1st quarter (published September 23, 2020)
SFY2020 4th quarter (published June 12, 2020)
SFY2020 3rd quarter (updated June 12, 2020)
SFY2020 2nd quarter (published January 3, 2020)
SFY2020 1st quarter (published September 23, 2019)
View all Hospital Safety Net Assessment payments

Critical Access Hospital (CAH) grant payments

SFY2023 (published April 10, 2023)
SFY2022 (published March 22, 2022)
SFY2021 (published April 19, 2021)
SFY2020 (published March 26, 2020)
SFY2019 (published February 26, 2019)
SFY2018 (published March 26, 2018)
SFY2017 (updated June 14, 2017)
SFY2016 (published June 21, 2016)

Revised Code of Washington (RCW) information

Chapter 74.60 - Hospital Safety Net Assessment

Inpatient Prospective Payment System (IPPS)

Inpatient provider rates (includes outpatient ratio of cost to charges (RCC) rates)

September 1, 2023 - current (updated September 18, 2023)
August 1, 2023 - August 31, 2023 (updated September 18, 2023
July 1, 2023 - July 31, 2023 (updated September 18, 2023)
May 1, 2023 - June 30, 2023 (updated April 28, 2023)
February 1, 2023 - April 30,2023 (updated January 31, 2023)
November 1, 2022 - January 31, 2023 (updated October 31, 2022)
August 1, 2022 - October 31, 2022 (updated August 10, 2022)
July 1, 2022 - July 31, 2022 (updated August 4, 2022)
May 1, 2022 - June 30, 2022 (updated April 29, 2022)
February 1, 2022 - April 30, 2022 (updated January 31, 2022)
November 1, 2021 - January 31, 2022 (updated October 29, 2021)
August 1, 2021 - October 31, 2021 (updated July 28, 2021)
July 1, 2021 - July 31, 2021 (updated August 6, 2021)
View all Inpatient Prospective Payment System (IPPS) rates

Diagnosis-related group (DRG) calculator

September 2023 DRG Calculator (updated September 18, 2023)
August 2023 DRG Calculator (updated September 18, 2023)
July 2023 DRG Calculator (updated September 18, 2023)
April 2023 DRG Calculator (published April 28, 2023)
February 2023 DRG Calculator (published January 31, 2023)
November 2022 DRG Calculator (published October 31, 2022)
August 2022 DRG calculator (updated September 16, 2022)
July 2022 DRG calculator (published June 27, 2022)

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, 2023 - current (updated July 5, 2023)
July 1, 2022 - June 30, 2023 (published June 9, 2022)
July 1, 2021 - June 30, 2022 (published June 14, 2021)
July 1, 2020 - June 30, 2021 (published June 29, 2020)
July 1, 2019 - June 30, 2020 (published June 26, 2019)
July 1, 2018 - June 30, 2019 (published June 19, 2018)
July 1, 2017 - June 30, 2018 (published June 12, 2017)
View all Quality Incentive Payments (QIP) hospital scores

Additional information

Outpatient Prospective Payment System (OPPS)

Ratio of cost to charges (RCC) rates

Inpatient rates (includes outpatient RCC)

Provider conversion factors

July 1, 2023 - current (updated September 19, 2023)
April 1, 2023 - June 20, 2023 (updated March 30, 2023)
January 1, 2023 - March 31, 2023 (updated February 28, 2023)
October 1, 2022 - December 31, 2022 (updated October 12, 2022)
July 1, 2022 - September 30, 2022 (updated October 12, 2022)
April 1, 2022 - June 30, 2022 (updated October 12, 2022)
January 1, 2022 - March 31, 2022 (published January 3, 2022)
October 1, 2021 - December 31, 2021 (updated October 13, 2021)
July 1, 2021 - September 30, 2021 (updated October 13, 2021)
April 1, 2021 - June 30, 2021 (updated April 15, 2021)
View all OPPS provider conversion factors

EAPG Calculator

July 2023 EAPG Calculator (published July 3, 2023)
April 2023 EAPG Calculator (published April 3, 2023)
January 2023 EAPG Calculator (published January 9, 2023)
October 2022 EAPG Calculator (published December 1, 2022)
July 2022 EAPG Calculator (published December 14, 2022)

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

Payments

SFY2023 3rd distribution (published July 19, 2023)
SFY2023 2nd distribution (published April 4, 2023)
SFY2023 1st distribution (published January 5, 2023)
SFY2022 5th distribution (published June 21, 2023)
SFY2022 4th distribution (published November 2, 2022)
SFY2022 3rd distribution (published August 2, 2022)
SFY2022 2nd distribution (published May 4, 2022)
SFY2022 1st distribution (published February 2, 2022)
SFY2021 5th distribution (published June 10, 2022)
SFY2021 4th distribution (updated December 20, 2021)
SFY2021 3rd distribution (updated December 20, 2021)
SFY2021 2nd distribution (published May 4, 2021)
SFY2021 1st distribution (published February 2, 2021)
SFY2020 5th distribution (published June 7, 2021)
SFY2020 4th distribution (published November 4, 2020)
SFY2020 3rd distribution (published August 5, 2020)
SFY2020 2nd distribution (published May 7, 2020)
SFY2020 1st distribution (published February 5, 2020)
View all Trauma payments

Additional information

Department of Health - Trauma System

Contact

Office of Hospital Finance