HCA Upgrade of APR-DRG Grouper Version - April 2018

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Apple Health (Medicaid) Provider

Attention Hospital Administrators: 

Effective for hospital admission dates on and after April 1, 2018, the Health Care Authority (agency) will upgrade the APR-DRG grouper version in ProviderOne, from 31 to 33. The reason for this upgrade is that APR-DRG version 33 is fully ICD-10 compliant.  

The agency performed an analysis to determine the impacts of upgrading to ARP-DRG version 33. The analysis confirmed the following:  

  • No algorithmic changes between APR-DRG grouper versions 31 and 33
  • No DRG weight changes between APR-DRG grouper version 31 and 33
  • No need to apply budget neutrality factors to APR-DRG version 33