Texas Medicaid uses an All Patient
Refined – Diagnosis Related Groups (APR-DRG) payment system for inpatient
hospital providers that are reimbursed based on a DRG payment methodology. The APR-DRG methodology focuses on all Medicaid client populations and
addresses patient severity of illness and patient risk of mortality in addition
to patient resource intensity.
DRG Conversion (APR-DRG) Frequently Asked Questions
Note: Effective for admissions on or after September 1, 2013, children’s
and rural hospitals are reimbursed using the prospective payment methodology
based on APR-DRGs and are no longer reimbursed according to the Tax Equity and
Fiscal Responsibility Act of 1982 (TEFRA) methodology.