APR-DRGs

All Patient Refined-Diagnosis Related Groups

APR-DRGs expand on MS-DRGs by incorporating severity of illness and risk of mortality into the classification. These rates are negotiated and may vary significantly.

For hospitals with APR-DRG-based contracts, Turquoise includes these rates in the MRF by calculating the negotiated amount. When full calculation isn't feasible, such as with certain Medicaid payment methodologies, we provide the relevant algorithm details to ensure compliance and transparency.