HCA upgrade of APR-DRG grouper version in ProviderOne

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Apple Health (Medicaid) Provider Alert

Attention Hospital Administrators: 

As a reminder, the Washington State Health Care Authority (HCA) will upgrade the APR-DRG grouper version in ProviderOne, from 31 to 33. HCA will implement the updated grouper version 33 on April 1, 2018, for admission dates on or after April 1, 2018. The upgrade to APR-DRG version 33 is necessary because it is fully ICD-10 compliant.  

HCA performed an analysis to determine the impacts of upgrading to ARP-DRG version 33. HCA’s 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