Archived Inpatient and Outpatient Rates and Weights

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	While some disruption is still occurring due to the cyber security incident involving Change Healthcare, providers who use Change Healthcare may once again submit pharmacy Point-of-Sale claims. Visit the ForwardHealth Change Healthcare Service Interruption: Resources page for more information. Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences. Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.

Archived Inpatient & Outpatient Hospital DRG Rates

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Inpatient Hospital APR-DRG Rates

Please note: Inpatient Hospital DRG Rates follow state fiscal year cycles (eg: SFY2004 = 7/1/2003 - 6/30/2004).

Rates Effective 1/1/2021 PDF	Rates Effective 1/1/2021 Excel
Rates Effective 1/1/2020 PDF	Rates Effective 1/1/2020 Excel
Rates Effective 1/1/2019 PDF	Rates Effective 1/1/2019 Excel
Rates Effective 1/1/2018 PDF	Rates Effective 1/1/2018 Excel
Rates Effective 1/1/2017 PDF	Rates Effective 1/1/2017 Excel
Rates Effective 1/1/2016 PDF	Rates Effective 1/1/2016 Excel
Rates Effective 7/1/2015 (i.e. New access payments) PDF	Rates Effective 7/1/2015 (i.e. New access payments) Excel
Rates Effective 1/1/2015 PDF	Rates Effective 1/1/2015 Excel
Rates Effective 7/1/2014 (i.e. New access payments) PDF	Rates Effective 7/1/2014 (i.e. New access payments) Excel
Rates Effective 1/1/2014 PDF	Rates Effective 1/1/2014 Excel
Rates Effective 7/1/2013 (i.e. New access payments) PDF	Rates Effective 7/1/2013 (i.e. New access payments) Excel
Rates Effective 2/1/2013 PDF	Rates Effective 2/1/2013 Excel
Rates Effective 7/1/2012 PDF	Rates Effective 7/1/2012 Excel
Rates for SFY2012 PDF	Rates for SFY2012 Excel
Rates for SFY2011 PDF	Rates for SFY2011 Excel

Outpatient Hospital EAPG Rates

Please note: Outpatient Hospital Rates follow state fiscal year cycles (eg: SFY2004 = 7/1/2003 - 6/30/2004).

EAPG Rates Effective 1/1/2021 PDF	EAPG Rates Effective 1/1/2021 Excel
EAPG Rates Effective 1/1/2020 PDF	EAPG Rates Effective 1/1/2020 Excel
EAPG Rates Effective 1/1/2019 PDF	EAPG Rates Effective 1/1/2019 Excel
EAPG Rates Effective 1/1/2018 PDF	EAPG Rates Effective 1/1/2018 Excel
EAPG Rates Effective 1/1/2017 PDF	EAPG Rates Effective 1/1/2017 Excel
EAPG Rates Effective 1/1/2016 PDF	EAPG Rates Effective 1/1/2016 Excel
EAPG Rates Effective 7/1/2015 (i.e. New access payments) PDF	EAPG Rates Effective 7/1/2015 (i.e. New access payments) Excel
EAPG Rates Effective 1/1/2015 PDF	EAPG Rates Effective 1/1/2015 Excel
EAPG Rates Effective 7/1/2014 (i.e. New access payments) PDF	EAPG Rates Effective 7/1/2014 (i.e. New access payments) Excel
EAPG Rates Effective 1/1/2014 PDF	EAPG Rates Effective 1/1/2014 Excel
EAPG Rates Effective 7/1/2013 (i.e. New access payments) PDF	EAPG Rates Effective 7/1/2013 (i.e. New access payments) Excel
EAPG Rates Effective 4/1/2013 PDF	EAPG Rates Effective 4/1/2013 Excel

Inpatient Hospital MS-DRG Weights

Please note: Inpatient Hospital DRG Weights follow state fiscal year cycles (eg: SFY2004 = 7/1/2003 - 6/30/2004).

Outpatient Hospital EAPG Weights

Text Format For 3M Software use	Microsoft Excel Format Not for 3M Software use
Effective 1/1/2021	Effective 1/1/2021
Effective 1/1/2020	Effective 1/1/2020
Effective 1/1/2019	Effective 1/1/2019
Effective 1/1/2018	Effective 1/1/2018
Effective 1/1/2017	Effective 1/1/2017
Effective 1/1/2016	Effective 1/1/2016
Effective 1/1/2015	Effective 1/1/2015
Effective 1/1/2014	Effective 1/1/2014
Effective 4/1/2013	Effective 4/1/2013

Medicaid Outpatient Hospital Rates-per-visit (only apply to County Jail Inmates)

Outpatient Per Visit Rates Effective 1/1/2021 PDF	Outpatient Per Visit Rates Effective 1/1/2021 Excel
Outpatient Per Visit Rates Effective 1/1/2020 PDF	Outpatient Per Visit Rates Effective 1/1/2020 Excel
Outpatient Per Visit Rates Effective 1/1/2019 PDF	Outpatient Per Visit Rates Effective 1/1/2019 Excel
Outpatient Per Visit Rates Effective 1/1/2018 PDF	Outpatient Per Visit Rates Effective 1/1/2018 Excel
Outpatient Per Visit Rates Effective 7/1/2015 (i.e. New access payments) PDF	Outpatient Per Visit Rates Effective 7/1/2015 (i.e. New access payments) Excel
Outpatient Per Visit Rates Effective 1/1/2015 PDF	Outpatient Per Visit Rates Effective 1/1/2015 Excel
Outpatient Per Visit Rates Effective 7/1/2014 (i.e. New access payments) PDF	Outpatient Per Visit Rates Effective 7/1/2014 (i.e. New access payments) Excel
Outpatient Per Visit Rates Effective 1/1/2014 PDF	Outpatient Per Visit Rates Effective 1/1/2014 Excel
Outpatient Per Visit Rates Effective 7/1/2013 (i.e. New access payments) PDF	Outpatient Per Visit Rates Effective 7/1/2013 (i.e. New access payments) Excel
Outpatient Per Visit Rates Effective 2/1/2013 PDF	Outpatient Per Visit Rates Effective 2/1/2013 Excel
Outpatient Per Visit Rates Effective 7/1/2012 PDF	Outpatient Per Visit Rates Effective 7/1/2012 Excel
Outpatient Per Visit Rates for SFY2012 PDF	Outpatient Per Visit Rates for SFY2012 Excel
Outpatient Per Visit Rates for SFY2011 PDF	Outpatient Per Visit Rates for SFY2011 Excel

Cost Center Crosswalks and DRG Enhancement Tables

Rate Year 2019 Outpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2018 Outpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2017 Outpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2016 Outpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2019 Inpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2018 Inpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2017 Inpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Inpatient Hospital DRGs for Mental Diseases and Disorders Crossover Chart from Medicare (T18) DRG to Wisconsin Medicaid DRGs — Excel | PDF
Rate Year 2016 Inpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF
Rate Year 2015 HCRIS Code to Cost Center Crosswalk — Excel | PDF
Rate Year 2015 Inpatient Revenue Code Crosswalk to Suggested Cost Centers — Excel | PDF

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