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Attention inpatient hospital providers:
Effective for claims with dates of service on or after January 1, 2026, the Health Care Authority (HCA) updated the Inpatient Hospital Services Billing Guide.
What is Changing?
- Replaced 3M™ with Solventum
- The payments for outlier enhancements have exceeded the budget neutral amount calculated during the 2021 hospital rebasing period. An increase in the outlier threshold from $40,000 to $45,000 allows the state to bring payments more in line with the budget neutral number calculated in 2021.
See the What has changed table in the January 15, 2026, publication of this guide for additional information.
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