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 23, 2022)
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, 2022 - present (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 SFY2022 (updated May 5, 2022)
- Low income DSH SFY2021 (updated June 30, 2021)
- Low income DSH SFY2020 (updated May 11, 2020)
- 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 23, 2022)
- 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 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
- 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
- Inpatient Prospective Payment System (IPPS)
-
Inpatient provider rates (includes outpatient ratio of cost to charges (RCC) rates)
- November 1, 2022 - present (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
- November 2022 DRG Calculator (posted 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, 2022 - current (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
Provider conversion factors
- October 1, 2022 - present (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 2022 EAPG Calculator (published June 27, 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
- 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