Final APR-DRG Weights Effective January 1, 2021 (v34)

APR-DRG Weights and ALOS for Acute Services

January 1, 2021 Inpatient Rate Update

The APR-DRG weights effective January 1, 2021 will not be updated. For discharges beginning on or after January 1, 2021, the SIWs, cost thresholds and ALOS effective July 1, 2018 will be used for payment purposes with the APR-DRG grouper version 34. Please refer to "Final APR-DRG Weights effective July 1, 2018 (v34)" for the weights utilized effective January 1, 2021.

In addition, since the grouping is developed by 3M using clinical logic, if a claim does not group to an APR-DRG as the provider expects it to group, the provider will need to contact 3M to discuss the grouping logic. If 3M does determine, based on their clinical review, that the grouping should be revised, the Department is requesting the provider submit an email to informing the Department about the grouping logic discussion with 3M and the outcome for informational purposes.