MedicaidReimbursementHigh impact
BT202090: IHCP announces updated changes to DRG grouper and cost-to-charge ratios
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Aug 1, 2020
We identified it
Jun 19, 2026
Summary
IHCP (Indiana Medicaid) has updated DRG base rates, outlier thresholds, and level-of-care per diem rates effective August 1, 2020. The DRG base rate increases to $3,523.75 for acute care hospitals and $4,228.50 for children's hospitals, with the outlier threshold set at $56,350.
Action Required
By August 1, 2020: Billing team must update billing system with new IHCP rates - DRG base rate $3,523.75 for acute care hospitals, $4,228.50 for children's hospitals, outlier threshold $56,350, and new level-of-care per diem rates (Psychiatric $408.50, Rehabilitation $667.00, Burn/1 $2,850.00, Burn/2 $855.00). Update cost-to-charge ratios as needed and verify medical education rates with Myers and Stauffer if applicable.