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DRG Calculator January 2020 Update - Posted 12.31.2019 pdf

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

The Connecticut Medicaid DRG Calculator has been updated with new payment rates, weights, and outlier thresholds effective January 1, 2020. Hospital billing teams must use the updated calculator for all inpatient discharges from January 1, 2020 forward.

Action Required

Action needed
Immediately: Hospital billing teams must access and use the updated DRG Calculator from the Hospital Modernization Web Page for all inpatient discharge calculations effective January 1, 2020 and forward. Verify updated Adjusted Base Rates, IME Factors, and Cost-to-Charge ratios in the Provider Table CT tab. Update systems with new Behavioral Health and Rehab per diem rates for services starting January 1, 2020.