MedicaidReimbursementHigh impact
DSS Important Message - DRG Calculator Updated
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
The Connecticut Department of Social Services has updated the DRG Calculator with new DRG weights, average length of stays, outlier thresholds, hospital rates, and behavioral health/rehab per diem rates effective January 1, 2025. This affects reimbursement calculations for inpatient hospital services.
Action Required
By January 1, 2025: Billing team must download and implement the updated DRG Calculator from the Hospital Modernization Web Page at ctdssmap.com. Update billing system with new DRG weights, average length of stays, outlier thresholds, and updated hospital rates including Adjusted Base Rate, IME Factor, and Cost-to-Charge ratios. Update behavioral health and rehab per diem rates for proper reimbursement calculations.