Hospital reimbursement

Rates and program information

Certified Public Expenditures (CPE)

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

• Section 182-550-4650 - Payment program
• Section 182-550-4670 - Hold harmless
• Section 182-550-4700 - Authorization and utilization review
• Section 182-550-5410 - Medicaid cost reports

Critical Access Hospitals (CAH)

Interim rates

• January 1, 2025 - present (updated January 13, 2025)
• January 1, 2024 - December 31, 2024 (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)
• 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)

Payments

• Low income DSH SFY2025 (published February 5, 2025)
• 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 SFY2025 (published February 5, 2025)
• 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)
• See All Hospital Safety Net FFS payments

Critical Access Hospital (CAH) grant payments

• SFY2024 (updated July 2, 2024)
• SFY2023 (updated July 2, 2024)
• SFY2022 (updated July 2, 2024)
• See All Hospital Safety Net CAH grant payments

Distressed Hospital Grant

• CY2025 Distressed Grant Application (published April 11, 2025)
• 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 4th quarter (published March 27, 2025)
• 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 4th quarter (published March 27, 2025)
• 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

• Chapter 74.60 - Hospital Safety Net Assessment

Inpatient Prospective Payment System (IPPS)

Inpatient provider rates

• May 1, 2025 - present (proposed) (published April 15, 2025)
• February 1, 2025 - April 30, 2025 (updated March 4 , 2025)
• November 1, 2024 - January 31, 2025 (updated March 4, 2025)
• October 1, 2024 - October 31, 2024 (updated March 4, 2025)
• September 1, 2024 - September 30, 2024 (updated March 4 , 2025)
• August 1, 2024 - August 31, 2024 (updated January 31, 2025)
• July 1, 2024 - July 31, 2024 (updated January 31, 2025)
• May 1, 2024 - June 30, 2024 (updated January 8, 2025)
• February 1, 2024 - April 30, 2024 (updated January 8, 2025)
• January 1, 2024 - January 31, 2024 (updated January 8, 2025)
• 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

• February 1, 2025 DRG Calculator (updated March 4, 2025)
• November 1, 2024 DRG Calculator (updated March 4, 2025)
• October 1, 2024 DRG Calculator (published March 10, 2025)
• September 1, 2024 DRG Calculator (published March10, 2025)
• August 1, 2024 DRG Calculator (updated January 31, 2025)
• July 1, 2024 DRG Calculator (updated January 31, 2025)
• 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

• Billing guides
• HCA revenue code grids

Outpatient Prospective Payment System (OPPS)

Provider conversion factors

• April 1, 2025 - present  (updated April 1, 2025)
• January 1, 2025 - March 31, 2025 (published December 31, 2024)
• October 1, 2024 -December 31, 2024 (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

• April 2025 EAPG Calculator (published April 1, 2025)
• January 2025 EAPG Calculator (published December 31, 2024)
• 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

• Billing guides and fee schedules
• HCA revenue code grids

Trauma Program

Payments

• SFY2025 2nd distribution Level 2-3 hospitals (published April 3, 2025)
• SFY2025 2nd distribution Graduate Medical Education - Trauma hospitals (published April 3, 2025)
• SFY2025 1st distribution Level 2-3 hospitals (published January 3, 2025)
• SFY2025 1st distribution Graduate Medical Education - Trauma hospitals (published January 3, 2025)
• 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

• Department of Health - Trauma System