Diagnosis Related Group (DRG) Important Information
Below you will find important information regarding DRG.
Policy Document
- Medi-Cal DRG Project Policy Design Document September 2013 (PDF)
- DRG Year 3 HSRV Memorandum June 2015 (PDF)
All Plan Letter (APL)
- APL 19-008 Rate Changed for Out-of-Network Border Hospitals under the DRG Methodology June 2019 (PDF)
- APL 16-007 Designated Public Hospitals: Billing for Beneficiaries with California Children’s Services Eligible Conditions and/or Medi-Cal Managed Care (Supersedes APL 15-011) JULY 2016 (PDF)
- APL 16-008 Billing for CCS and Managed Care (supersedes APL 13-012) JULY 2016 (PDF)
- APL 16-016 Rates Changes for Emergency and Post-Stabilization Services Provided by Out-of-Network “Border” Hospitals Under the Diagnosis Related Group Payment Methodology December 2016 (PDF)
Approved State Plan Amendments (SPA)
Approved State Plan Amendment 25-0022 (PDF)
Approved State Plan Amendment 24-0017 (PDF)
Approved State Plan Amendment 23-0014 (PDF)
Approved State Plan Amendment 22-0029 (PDF)
Approved State Plan Amendment 21-0021 (PDF)
Approved State Plan Amendment 20-0019 (PDF)
Approved State Plan Amendment 19-0025 (PDF)
Approved State Plan Amendment 18-013 (PDF)
Approved State Plan Amendment 17-032 (PDF)
Approved State Plan Amendment 17-015 (PDF)
Approved State Plan Amendment 16-011 (PDF)
Approved State Plan Amendment 15-033 (PDF)
Approved State Plan Amendment 15-020 (PDF)
Approved State Plan Amendment 15-014 (PDF)
Approved State Plan Amendment 14-014 (PDF)
Approved State Plan Amendment 13-033 (PDF)
Approved State Plan Amendment 13-004 (PDF)