Attachment_6_-_Computation_of_Basic_MS-DRG_USP_CANAAN_1.pdf

Attachment 6 –USP CANAAN Computation of Basic MS-DRG Payments (i.e., Operating Federal Rate)

CBSA 42540-Scranton-Wilkes-Barre-Hazleton, PA 15B21518R00000001

Calculation of the Operating Federal Rate:

Step 1: Select the applicable average standardized amount for the full update

Step 2: Multiply the labor-related portion of the standardized amount by the applicable wage index for the geographic area

Step 3: For hospitals in Alaska and Hawaii, multiply the non-labor-related portion of the standardized amount by the applicable cost-of-living adjustment factor

Step 4: Add the amount from Step 2 and the non-labor-related portion of the standardized amount (adjusted, if applicable, under Step 3)

Step 5: Multiply the final amount from Step 4 by the relative weight corresponding to the applicable MS-DRG

Index Figures: Obtained from the Centers for Medicare & Medicaid Services, bop for discharges on/after October 1, 2018.

Table 1B, National Adjusted Operating Standardized Amount:

Labor-related: $3506.83 Non-labor-related: $2149.35

Table 3, Wage Index Table by CBSA (42540, Scranton-Wilkes-Barre-Hazleton, PA): .8541

Table, Cost of Living Adjustment Factor: Not applicable

Table 5, MS-DRG Relative Weight (MS-DRG 76, Viral Meningitis w/o CC/MCC): 0.8200

Application for MS-DRG 076 (example):

Step 1: $3,506.83 Step 2: $3,506.83 X 0.8541= $2,995.18 Step 3: Not applicable Step 4: $2995.18+ $2,149.35 = $5,144.53 Step 5: $5,144.53 X 0.8200= $4,218.52 Payment for MS-DRG 076 under the contract would be $4,218.52 plus or minus any premium or discount established as the contract rate.