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Nov 1, 2024

Payment Policy Updates

The following payment guidelines are applicable to local in-network facilities only that are reimbursed as a DRG, excluding mental health, maternity, and rehabilitation. Transfer logic only applied to transfer status 02, 05, and 63. 

Discharge CodeDescription
02Discharged / transferred to a short-term general hospital for inpatient care
05Discharged / transferred to a designated cancer center or children’s hospital
65Discharged / transferred to long term care hospitals (LTCH)

For additional details related to this policy, please click here