Attachment_1_-_Computation_of_Basic_MS-DRG_1.pdf

Attachment 1 –RFPP05041500002 Computation of Basic MS-DRG Payments (i.e., Operating Federal Rate)

CBSA 17780 – College Station – Bryan, TX

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 nonlabor-related portion of the standardized amount by the applicable cost-of-living adjustment factor

Step 4: Add the amount from Step 2 and the nonlabor-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 Federal Register, Vol. 79, No. 192, Friday, October 3, 2014, for discharges on/after October 1, 2014.

Table 1B, National Adjusted Operating Standardized Amount:

Labor-related: $3,371.47 Non-labor-related: $2,066.38

Table 4A, Wage Index for Urban Areas by CBSA (17780, College Station - Bryan, TX): 0.8974

Table, Cost of Living Adjustment Factor: Not applicable

Table 5, MS-DRG Relative Weight (MS-DRG 76, Viral Meningitis w/o CC/MCC): 0.8629

Application for MS-DRG 076 (example):

Step 1: $3,371.47 Step 2: $3,371.47 X 0.8974 = $3,025.55 Step 3: Not applicable Step 4: $3,025.55 + $2,066.38 = $5,091.93 Step 5: $5,091.93 X 0.8629 = $4,210.51

Payment for MS-DRG 076 under the contract would be $4,210.51 plus or minus any premium or discount established as the contract rate.