Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Methods and Standards for Establishing Payment Rates; in-Patient Hospital Care [12 VAC 30 ‑ 70]
All Patient-Refined DRG Payment Methodology
Action 4324
General Information
Action Summary This regulation replaces the All Patient Diagnosis-Related Group (AP-DRG) classification system with the All Patient Refined Diagnosis-Related Group (APR-DRG) system for inpatient hospital operating reimbursement. Effective October 1, 2014, the new grouper described in the regulatory action shall replace the existing DRG classification system. This action shall also update reimbursement for non cost-reporting hospitals.
Chapters Affected Only affects this chapter.
Executive Branch Review This action will go through the normal Executive Branch Review process.
RIS Project Yes  [004280]
Associated Mandates Implement APR-DRG Reimbursement Methodology
New Periodic Review This action will not be used to conduct a new periodic review.
Stages associated with this regulatory action.
Stage ID Stage Type Status
7161 Fast-Track Stage complete. This regulation became effective on 02/25/2016.
Contact Information
Name / Title: Emily McClellan  / Regulatory Supervisor
Address: Policy Division, DMAS
600 E. Broad Street, Suite 1300
Richmond, VA 23219
Email Address:
Phone: (804)371-4300    FAX: (804)786-1680    TDD: ()-

This person is the primary contact for this chapter.