MedicaidReimbursementHigh impact
BT202077: IHCP announces changes to DRG grouper and inpatient hospital reimbursement rates
Indiana Medicaid (IHCP)·IN·Claims & Billing
Effective date
Aug 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Health Coverage Programs (IHCP) is updating from APR-DRG version 30 to version 36 for inpatient hospital reimbursement, with new DRG base rates, relative weights, and updated outlier thresholds. The DRG base rate increases to $3,624.35 for acute care hospitals and $4,349.22 for eligible children's hospitals.
Action Required
By August 1, 2020: Billing teams at Indiana hospitals must update their DRG grouper software to APR-DRG version 36 and ensure billing systems reflect the new base rates ($3,624.35 for acute care, $4,349.22 for children's hospitals) and updated relative weights. Contact 3M at 1-800-367-2447 to obtain the new APR-DRG software. Verify that DRG 757 claims with ICD-10 diagnosis codes F70-F79 are processed using DRG payment methodology rather than psychiatric LOC per diem rates.