MS-DRGs

Medicare Severity-Diagnosis Related Groups

MS-DRGs are used to classify hospital inpatient stays. Each MS-DRG is assigned a payment rate based on the average resources required to treat patients in that category. MS-DRGs are usually not assigned Gross Charge or Cash Price amounts in the MRF as the amounts are variable based on the services provided during the inpatient stay.

Turquoise includes MS-DRGs in an MRF when they are used in payer contract agreements to derive the negotiated rate. Examples include Medicare Advantage contracts based on IPPS (such as "105% of the Medicare allowable") and commercial payer surgery or maternity case rates.