DRG rate definition

DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse hospitals for routine and ancillary costs of providing care for an inpatient stay.
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DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse
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DRG rate means the all inclusive dollar amount applied to the appropriate DRG Weight which results in the Anthem Rate, if the reimbursement methodology as set forth in the PCS is on a DRG basis.
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Examples of DRG rate in a sentence

  • Certain DRGs are established to specifically include only transfer cases; for these DRGs, reimbursement shall be equal to the DRG rate.

  • The per diem rate is determined by dividing the appropriate DRG rate by the geometric mean LOS for the specific DRG to which the case is assigned.

  • In such instances, policy requires that each hospital’s payment will be the lesser of the DRG rate or a rate calculated by the cost-to-charge ratio (CCR).

  • For example, the PSI Software reports the low-mortality DRG rate for all the included DRGs and separately by DRG type: adult medical, adult surgical (with and without an operating room procedure), pediatric medical, pediatric surgical (with and without an operating room procedure), and obstetric and psychiatric.

  • House Bill 71, Second Extraordinary Session of 2009, requires that the Mississippi Division of Medicaid develop and publish a set of reimbursement rates that are at least equal to those allowed under Medicare for the identical or closely related Medicare Diagnosis Related Groups (DRG) rate.

  • Contractors are required to pay HAF hospitals at the enhanced Medicaid rates for HAF eligible services detailed below:  HAF eligible hospitals  Contracted providers: MCEs shall pay 100% of the enhanced (HAF) rates, which is 100% of the fee schedule rate multiplied by the HAF factor OR 100% of the Inpatient APR DRG rate multiplied by the HAF factor.

  • Each relative weight is multiplied by the base amount to determine the DRG rate.

  • The actual payment received from the third-party payer is subject to adjustments to the gross DRG rate initially billed by the hospital.

  • It required hospitals to bill Blue Cross/Blue Shield insurers at the DRG rate and to level a substan- tial surcharge on top of those rates on all non-Blue insurers.

  • The hospital's total payment for the case will be the DRG rate specified in Section V plus the outlier payment as described in this section.


More Definitions of DRG rate

DRG rate means the product of the relative weight multiplied by the base amount. It is the amount paid to reimburse hospitals for routine and ancillary costs
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Related to DRG rate

  • Adjusted LIBOR Rate means, at any time with respect to any LIBOR Loan, a rate per annum equal to the LIBOR Rate as in effect at such time plus the Applicable Margin Percentage for LIBOR Loans as in effect at such time.

  • LIBOR Rate means a rate per annum (rounded upwards, if necessary, to the next higher 1/100th of 1%) determined by the Administrative Agent pursuant to the following formula: LIBOR Rate = LIBOR 1.00-Eurodollar Reserve Percentage

  • Base Rate means, for any day, the rate per annum equal to the higher of (a) the Federal Funds Rate for such day plus one-half of one percent (0.5%) and (b) the Prime Rate for such day. Any change in the Base Rate due to a change in the Prime Rate or the Federal Funds Rate shall be effective on the effective date of such change in the Prime Rate or Federal Funds Rate.

  • Reference Rate means the rate specified as such hereon.