Hospital reimbursement

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

• Section 182-550-4650 - Payment program
• Section 182-550-4670 - Hold harmless
• Section 182-550-4700 - Authorization and utilization review
• Section 182-550-5410 - Medicaid cost reports

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 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 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

• 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)

• February 1, 2023 - present  (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

• 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, 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

• Billing guides
• HCA revenue code grids

Outpatient Prospective Payment System (OPPS)

Ratio of cost to charges (RCC) rates

• Inpatient rates (includes outpatient RCC)

Provider conversion factors

• April 1, 2023 - present (proposed) (published March 16, 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

• 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

• Billing guides and fee schedules
• HCA revenue code grids

Trauma Program

Payments

• SFY2023 1st distribution (published January 5, 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