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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
Disproportionate Share Hospital (DSH) application
- Application and instructions (updated June 19, 2018)
Medicaid cost report
- Cost report form (updated July 8, 2015)
- Cost report instructions (updated June 27, 2014)
Washington Administrative Code (WAC) information
Interim rates
- January 1, 2019 - current (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)
- January 1, 2014 - December 31, 2014 (published December 31, 2013)
Additional information
- HCA standard revenue code to cost center crosswalk (updated August 28, 2014)
- Department of Health - Critical Access Hospitals
Payments
- Low income DSH SFY2014 (updated March 17, 2015)
- Low income DSH SFY2013 (updated April 9, 2013)
- Low income DSH SFY2012 (updated July 1, 2012)
- Small rural DSH SFY2014 (published May 22, 2014)
- Small rural DSH SFY2013 (published July 14, 2012)
- Small rural DSH SFY2012 (updated July 1, 2012)
Calculations
- Low income DSH SFY2014 (updated March 17, 2015)
- Low income DSH SFY2013 (published April 9, 2013)
- Low income DSH SFY2012 (updated July 1, 2012)
- Small rural DSH SFY2014 (published June 9, 2014)
- Small rural DSH SFY2013 (updated June 9, 2014)
- Small rural DSH SFY2012 (updated July 1, 2012)
Utilization rates
- Low income DSH SFY2014 (published May 22, 2014)
- Low income DSH SFY2013 (updated April 9, 2013)
- Low income DSH SFY2012 (updated July 1, 2012)
Application and instructions (non-CPE)
- DSH application (updated June 22, 2018)
- 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)
Washington Administrative Code (WAC) information
Fee-for-service (FFS) payments
- SFY2019 3rd quarter (published February 26, 2019)
- SFY2019 2nd quarter (published December 14, 2018)
- SFY2019 1st quarter (published September 19, 2018)
- SFY2018 4th quarter (published June 20, 2018)
- SFY2018 3rd quarter (published March 26, 2018)
- SFY2018 2nd quarter (published December 18, 2017)
- SFY2018 1st quarter (published October 2, 2017)
- SFY2017 4th quarter (published June 13, 2017)
- SFY2017 3rd quarter (published March 28, 2017)
- SFY2017 2nd quarter (published December 30, 2016)
- SFY2017 1st quarter (published September 30, 2016)
- SFY2016 4th quarter (published June 21, 2016)
- SFY2016 3rd quarter (published April 25, 2016)
- SFY2016 2nd quarter (published December 18, 2015)
- SFY2016 1st quarter (updated December 18, 2015)
- SFY2015 4th quarter (published June 29, 2015)
- SFY2015 3rd quarter (published June 29, 2015)
Critical Access Hospital (CAH) grant payments
- SFY2019 (published February 26, 2019)
- SFY2018 (published March 26, 2018)
- SFY2017 (updated June 14, 2017)
- SFY2016 (published June 21, 2016)
- SFY2015 (published June 29, 2015)
Revised Code of Washington (RCW) information
Inpatient provider rates (includes outpatient ratio of cost to charges (RCC) rates)
- February 1, 2019 - current (published January 31, 2019)
- November 1, 2018 - January 31, 2019 (updated January 14, 2019)
- October 1, 2018 - October 31, 2018 (published January 14, 2019)
- August 1, 2018 - September 30, 2018 (updated November 1, 2018)
- July 1, 2018 - July 31, 2018 (updated August 13, 2018)
- May 1, 2018 - June 30, 2018 (updated August 13, 2018)
- February 1, 2018 - April 30, 2018 (updated August 13, 2018)
- January 1, 2018 - January 31, 2018 (updated March 6, 2018)
- November 1, 2017 - December 31, 2017 (updated March 6, 2018)
- October 1, 2017 - October 31, 2017 (updated March 6, 2018)
- August 1, 2017 - September 30, 2017 (updated August 25, 2017)
- July 1, 2017 - July 31, 2017 (updated August 3, 2017)
- May 1, 2017 - June 30, 2017 (updated August 3, 2017)
- February 1, 2017 - April 30, 2017 (updated August 3, 2017)
- January 1, 2017 - January 31, 2017 (updated August 3, 2017)
- November 1, 2016 - December 31, 2016 (updated March 31, 2017)
- August 1, 2016 - October 31, 2016 (updated March 31, 2017)
- July 1, 2016 - July 31, 2016 (updated March 31, 2017)
- June 1, 2016 - June 30, 2016 (updated March 31, 2017)
- February 1, 2016 - May 31, 2016 (updated March 31, 2017)
- January 1, 2016 - January 31, 2016 (updated March 31, 2017)
- November 1, 2015 - December 31, 2015 (published October 30, 2015)
- August 1, 2015 - October 31, 2015 (updated September 8, 2015)
- May 1, 2015 - July 31, 2015 (updated September 16, 2015)
- February 1, 2015 - April 30, 2015 (updated July 22, 2015)
- January 1, 2015 - January 31, 2015 (published December 31, 2014)
- November 1, 2014 - December 31, 2014 (updated November 21, 2014)
- August 1, 2014 - October 31, 2014 (updated October 27, 2014)
- July 1, 2014 - July 31, 2014 (updated October 5, 2015)
Diagnosis-related group (DRG) grouper weights and utilization/length of stay information
- April 1, 2018 - current (updated May 15, 2018)
- July 1, 2014 - March 31, 2018 (updated July 16, 2014)
Outlier factors
- July 1, 2014 - current (published July 2, 2014)
Quality Incentive Payments (QIP) hospital scores
- July 1, 2018 - current (published June 19, 2018)
- July 1, 2017 - June 30, 2018 (published June 12, 2017)
- July 1, 2016 - June 30, 2017 (published July 26, 2016)
- August 1, 2015 - June 30, 2016 (published July 20, 2015)
- July 1, 2014 - July 31, 2015 (updated March 6, 2015)
Additional information
Ratio of cost to charges (RCC) rates
Provider conversion factors
- January 1, 2019 - current (published December 27, 2018)
- October 1, 2018 - December 31, 2018 (published October 2, 2018)
- July 1, 2018 - September 30, 2018 (updated August 14, 2018)
- April 1, 2018 - June 30, 2018 (updated November 6, 2018)
- February 1, 2018 - March 31, 2018 (published January 31, 2018)
- January 1, 2018 - January 31, 2018 (updated January 10, 2018)
- October 1, 2017 - December 31, 2017 (updated November 20, 2017)
- July 1, 2017 - September 30, 2017 (updated September 11, 2017)
- April 1, 2017 - June 30, 2017 (updated July 31, 2017)
- January 1, 2017 - March 31, 2017 (updated January 30, 2017)
- October 1, 2016 - December 31, 2016 (updated November 2, 2016)
- July 1, 2016 - September 30, 2016 (published June 30, 2016)
- February 1, 2016 - June 30, 2016 (updated March 31, 2016)
- November 1, 2015 - January 31, 2016 (published October 30, 2015)
- August 1, 2015 - October 31, 2015 (published July 31, 2015)
- July 1, 2015 - July 31, 2015 (published June 30, 2015)
- January 1, 2015 - June 30, 2015 (published December 15, 2014)
- July 1, 2014 - December 31, 2014 (updated December 8, 2014)
Relative weights
- April 1, 2017 - current (updated March 17, 2017)
- July 1, 2014 - March 31, 2017 (updated June 26, 2014)
Additional information
Payments
- SFY2019 1st distribution (published February 4, 2019)
- SFY2018 4th distribution (published November 7, 2018)
- SFY2018 3rd distribution (published September 6, 2018)
- SFY2018 2nd distribution (published May 1, 2018)
- SFY2018 1st distribution (published February 1, 2018)
- SFY2017 4th distribution (published November 2, 2017)
- SFY2017 3rd distribution (published August 3, 2017)
- SFY2017 2nd distribution (published May 3, 2017)
- SFY2017 1st distribution (published February 1, 2017)
- SFY2016 final distribution (published June 21, 2018)
- SFY2016 4th distribution (published November 2, 2016)
- SFY2016 3rd distribution (published August 11, 2016)
- SFY2016 2nd distribution (published May 2, 2016)
- SFY2016 1st distribution (published February 1, 2016)
- SFY2015 final distribution (published January 4, 2018)
- SFY2015 4th distribution (published November 3, 2015)
- SFY2015 3rd distribution (published August 3, 2015)
- SFY2015 2nd distribution (published May 4, 2015)
- SFY2015 1st distribution (published February 2, 2015)