Archived Inpatient and Outpatient Rates and Weights

Welcome » May 1, 2025 7:50 AM

	Alerts
	Children’s Long-Term Support (CLTS) Program Providers and County Waiver Agencies: The CLTS Operations Team is available for your questions about submitting prior authorizations (PAs) or claims for CLTS services. Reach the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com. Attention CLTS Providers: The CLTS Prior Authorization Conversion is still processing. If you have any difficulties submitting claims, please contact the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com.

Archived Inpatient & Outpatient Hospital DRG Rates

Archived Inpatient and Outpatient Rates and Weights

You will need Adobe Reader^® to view the PDF files.

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 1/1/2022 PDF	Rates Effective 1/1/2022 Excel
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 1/1/2022 PDF	EAPG Rates Effective 1/1/2022 Excel
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).

Weights Effective 1/1/2022 PDF	Weights Effective 1/1/2022 Excel
Weights Effective 1/1/2021 PDF	Weights Effective 1/1/2021 Excel
Weights Effective 1/1/2020 PDF	Weights Effective 1/1/2020 Excel
Weights Effective 1/1/2019 PDF	Weights Effective 1/1/2019 Excel
Weights Effective 1/1/2018 PDF	Weights Effective 1/1/2018 Excel
Weights Effective 1/1/2017 PDF	Weights Effective 1/1/2017 Excel
Weights Effective 10/1/2015 PDF	Weights Effective 10/1/2015 Excel
Weights Effective 1/1/2014 PDF	Weights Effective 1/1/2014 Excel
Weights Effective 2/1/2013 PDF	Weights Effective 2/1/2013 Excel
Weights Effective 7/1/2011 PDF	Weights Effective 7/1/2011 Excel
Weights for SFY2011 PDF	Weights for SFY2011 Excel

Outpatient Hospital EAPG Weights

Text Format For 3M Software use	Microsoft Excel Format Not for 3M Software use
Effective 1/1/2022	Effective 1/1/2022
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 1/1/2022 PDF	Outpatient Per Visit Rates Effective 1/1/2022 Excel
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

About | Contact | Disclaimer | Privacy Notice

Wisconsin Department of Health Services

Production PROD_WIPortal2_M1000F__4

Browser Tab ID: 1 -1