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MedicaidReimbursementHigh impact

BT202059: IHCP announces changes to DRG grouper

Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Aug 1, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

Indiana Health Coverage Programs (IHCP) is updating their DRG grouper from APR-DRG version 30 to version 36 for inpatient hospital services. This change affects how inpatient stays are classified and reimbursed, with the new grouper applying to discharges on or after August 1, 2020.

Action Required

Action needed
By August 1, 2020: Hospital billing teams must ensure their systems are updated to use APR-DRG version 36 for all inpatient discharge coding. Contact 3M at 1-800-367-2447 to obtain the updated APR-DRG software. Monitor IHCP bulletins for DRG weight and rate updates that will be published at least 30 days before implementation. Failure to use the correct grouper version may result in incorrect reimbursement.