MedicaidReimbursementHigh impact
All Patient Refined Diagnosis Related Group (APR DRG)
Missouri Medicaid (MO HealthNet)·MO·Provider Bulletin
Effective date
Jun 17, 2026
We identified it
Jun 20, 2026
Summary
Missouri Medicaid has implemented a new All Patient Refined Diagnosis Related Group (APR DRG) system for inpatient billing and reimbursement. This represents a significant change from the previous DRG methodology and will affect how inpatient claims are processed and paid.
Action Required
By June 17, 2026: Billing teams must update inpatient billing systems to comply with new APR DRG methodology for Missouri Medicaid claims. Review the full bulletin document for specific implementation requirements and coding changes. Ensure staff are trained on APR DRG differences from standard DRG systems. Failure to comply may result in claim processing delays or denials.