Hospital reimbursement
This page provides information for hospitals serving Medicaid clients using the Washington State Medicaid Prospective Payment System (PPS fee-for-service).
Rates and program information
- Certified Public Expenditures (CPE)
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Disproportionate Share Hospital (DSH) application
- Application and instructions (updated June 1, 2024)
Medicaid cost report
- Cost report form (updated July 8, 2015)
- Cost report instructions (updated June 27, 2014)
Washington Administrative Code (WAC) information
- Critical Access Hospitals (CAH)
-
Interim rates
- January 1, 2024 - present (updated February 12, 2024)
- January 1, 2023 - December 31, 2023 (updated March 14, 2023)
- January 1, 2022 - December 31, 2022 (updated January 25, 2022)
- January 1, 2021 - December 31, 2021 (updated January 26, 2021)
- January 1, 2020 - December 31, 2020 (updated February 21, 2020)
- January 1, 2019 - December 31, 2019 (updated February 4, 2019)
- See all Critical Access Hospital rates
Additional information
- HCA standard revenue code to cost center crosswalk (updated August 28, 2014)
- Department of Health - Critical Access Hospitals
- Disproportionate Share Hospital (DSH)
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Payments
- Low income DSH SFY2024 (published July 9, 2024)
- Low income DSH SFY2023 (published July 12, 2023)
- Low income DSH SFY2022 (updated May 5, 2022)
- Low income DSH SFY2021 (updated June 30, 2021)
- Low income DSH SFY2020 (updated May 11, 2020)
- Small rural DSH SFY2024 (published July 9, 2024)
- Small rural DSH SFY2023 (published July 12, 2023)
- Small rural DSH SFY2022 (updated March 1, 2022)
- Small rural DSH SFY2021 (updated March 1, 2022)
- Small rural DSH SFY2020 (updated March 1, 2022)
Application and instructions (non-CPE)
- DSH application (updated July 1, 2024)
- DSH application troubleshooting (published July 1, 2012)
- Hospital Safety Net Program
-
Fee-for-service (FFS) payments
- CY 2024 4th quarter (published December 20, 2024)
- CY 2024 3rd quarter (published October 28, 2024)
- CY 2024 2nd quarter (published July 16, 2024)
- CY 2024 1st quarter (updated July 2, 2024) ** Changed from State fiscal year to Calendar year
- SFY 2024 2nd quarter (updated July 2, 2024)
- SFY 2024 1st quarter (updated July 2, 2024)
- SFY 2023 4th quarter (updated July 2, 2024)
- SFY 2023 3rd quarter (updated July 2, 2024)
- SFY 2023 2nd quarter (updated July 2, 20243)
- SFY 2023 1st quarter (updated July 2, 2024)
- SFY 2022 4th quarter (updated July 2, 20242)
- SFY 2022 3rd quarter (updated July 2, 20242)
- SFY 2022 2nd quarter (updated July 2, 2024)
Critical Access Hospital (CAH) grant payments
Distressed Hospital Grant
- CY2024 Distressed Grant Application (updated February 27, 2024)
Managed Care State Directed Payments
- CY2024 4th quarter (published November 27, 2024)
- CY2024 3rd quarter (published September 13, 2024)
- CY2024 2nd quarter (published August 28, 2024)
- CY2024 1st quarter (published July 16, 2024)
Designated Public Hospital (DPH) Inpatient Directed Payments
- CY2024 3rd quarter (published October 28, 2024)
- CY2024 2nd quarter (published July 16, 2024)
- CY2024 1st quarter (published July 16, 2024)
Designated Public Hospital (DPH) Outpatient Directed Payments
- CY2024 3rd quarter (published October 28, 2024)
- CY2024 2nd quarter (published July 16, 2024)
- CY2024 1st quarter (published July 16, 2024)
Revised Code of Washington (RCW) information
- Inpatient Prospective Payment System (IPPS)
-
Inpatient provider rates
- November 1, 2024 - present (updated November 5, 2024)
- October 1, 2024 - October 31, 2024 (updated November 1, 2024)
- August 1, 2024 - September 30, 2024 (updated November 1, 2024)
- July 1, 2024 - July 31, 2024 (updated November 1, 2024)
- May 1, 2024 - June 30, 2024 (updated April 30, 2024)
- February 1, 2024 - April 30, 2024 (updated February 1, 2024)
- January 1, 2024 - January 31, 2024 (updated February 1, 2024)
- November 1, 2023 - December 31, 2023 (updated January 2, 2024)
- September 1, 2023 - October 31, 2023 (updated January 2, 2024)
- August 1, 2023 - August 31, 2023 (updated January 2, 2024)
- July 1, 2023 - July 31, 2023 (updated January 2, 2024)
- May 1, 2023 - June 30, 2023 (updated April 28, 2023)
- February 1, 2023 - April 30,2023 (updated January 31, 2023)
- November 1, 2022 - January 31, 2023 (updated October 31, 2022)
- August 1, 2022 - October 31, 2022 (updated August 10, 2022)
- July 1, 2022 - July 31, 2022 (updated August 4, 2022)
- May 1, 2022 - June 30, 2022 (updated April 29, 2022)
- February 1, 2022 - April 30, 2022 (updated January 31, 2022)
- View all Inpatient Prospective Payment System (IPPS) rates
Diagnosis-related group (DRG) calculator
- November 1, 2024 DRG Calculator (published October 31, 2024)
- August 1, 2024 DRG Calculator (updated November 1, 2024)
- July 1, 2024 DRG Calculator (updated November 1, 2024)
- May 1, 2024 DRG Calculator (updated May 6, 2024)
- February 2024 DRG Calculator (updated May 13, 2024)
- January 2024 DRG Calculator (updated February 1, 2024)
- November 2023 DRG Calculator (updated May 13. 2024)
- September 2023 DRG Calculator (updated September 30, 2024)
- August 2023 DRG Calculator (updated May 16, 2024)
- July 2023 DRG Calculator (updated September 30, 2024)
- April 2023 DRG Calculator (published April 28, 2023)
- February 2023 DRG Calculator (published January 31, 2023)
- November 2022 DRG Calculator (published October 31, 2022)
- August 2022 DRG calculator (updated September 16, 2022)
- July 2022 DRG calculator (published June 27, 2022)
Diagnosis-related group (DRG) grouper weights and utilization/length of stay information
- July 1, 2022 - current (published June 2, 2022)
- April 1, 2018 - June 30, 2022 (updated May 15, 2018)
Outlier factors
- July 1, 2014 - current (published July 2, 2014)
Quality Incentive Payments (QIP) hospital scores
- July 1, 2024 - present (updated July 1, 2024)
- July 1, 2023 - June 30, 2024 (updated July 5, 2023)
- July 1, 2022 - June 30, 2023 (published June 9, 2022)
- July 1, 2021 - June 30, 2022 (published June 14, 2021)
- July 1, 2020 - June 30, 2021 (published June 29, 2020)
- July 1, 2019 - June 30, 2020 (published June 26, 2019)
- July 1, 2018 - June 30, 2019 (published June 19, 2018)
- July 1, 2017 - June 30, 2018 (published June 12, 2017)
- View all Quality Incentive Payments (QIP) hospital scores
Additional information
- Outpatient Prospective Payment System (OPPS)
-
Provider conversion factors
- October 1, 2024 - present (updated December 16, 2024)
- July 1, 2024 - September 30, 2024 (updated June 27, 2024)
- April 2024 - June 30, 2024 (updated March 28, 2024)
- January 2024 - March 31, 2024 (updated January 22, 2024)
- October 2023 - December 2023 (published September 28, 2023)
- July 1, 2023 - September 30, 2023 (updated September 19, 2023)
- April 1, 2023 - June 20, 2023 (updated March 30, 2023)
- January 1, 2023 - March 31, 2023 (updated February 28, 2023)
- October 1, 2022 - December 31, 2022 (updated October 12, 2022)
- July 1, 2022 - September 30, 2022 (updated October 12, 2022)
- April 1, 2022 - June 30, 2022 (updated October 12, 2022)
- January 1, 2022 - March 31, 2022 (published January 3, 2022)
- View all OPPS provider conversion factors
EAPG Calculator
- October 2024 EAPG Calculator (published October 1, 2024)
- July 2024 EAPG Calculator (published July 2, 2024)
- April 2024 EAPG Calculator (published March 28, 2024)
- January 2024 EAPG Calculator (updated January 17, 2024)
- October 2023 EAPG Calculator (published September 28, 2023)
- July 2023 EAPG Calculator (published July 3, 2023)
- April 2023 EAPG Calculator (published April 3, 2023)
- January 2023 EAPG Calculator (published January 9, 2023)
- October 2022 EAPG Calculator (published December 1, 2022)
- July 2022 EAPG Calculator (published December 14, 2022)
Relative weights
- July 1, 2022 - current (published June 2, 2022)
- April 1, 2017 - June 30, 2022 (updated March 17, 2017)
- July 1, 2014 - March 31, 2017 (updated June 26, 2014)
Additional information
- Trauma Program
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Payments
- SFY2024 3rd distribution (published July 10, 2024)
- SFY2024 2nd distribution (published April 1, 2024)
- SFY2024 1st distribution (updated February 26, 2024)
- SFY2023 4th distribution (published June 5, 2024)
- SFY2023 3rd distribution (published July 19, 2023)
- SFY2023 2nd distribution (published April 4, 2023)
- SFY2023 1st distribution (published January 5, 2023)
- SFY2022 5th distribution (published June 21, 2023)
- SFY2022 4th distribution (published November 2, 2022)
- SFY2022 3rd distribution (published August 2, 2022)
- SFY2022 2nd distribution (published May 4, 2022)
- SFY2022 1st distribution (published February 2, 2022)
- SFY2021 5th distribution (published June 10, 2022)
- View all Trauma payments
Additional information