Inpatient Hospital Per Diem Reimbursement Group

Implementation of Per Diem Update

2020 Updates


Split-Billing Guidance over the Implementation Date of July 1, 2019 has been approved. Please review the guidance document prior to resubmitting qualifying claims. Split- Bill Instructions. Please contact Andrew Abalos at for additional questions or assistance. 


The system update to automate payments of Long Term Acute Care Hospitals, Rehabilitation Hospitals, and Spine/Brain Injury Treatment Specialty Hospital was completed February 27, 2020, but had an issue related to crossover claims.

Claims will continue to suspend under edit 7500 until the error impacting Medicare Crossover claims are resolved. The Department will keep the Providers apprised of when the suspension edit is removed and full automation of claims begins. Claims, where Medicare is the primary payer, should continue to be billed in the interim. Additionally, the billing guidance to rebill claims which span the implementation date is almost complete and will be released to Providers shortly.  

February 19, 2020

The Department will be holding an Inpatient Per Diem Stakeholder meeting on Tuesday, February 25, 2020, from 10:00 am-11:00 am to discuss billing guidelines for the system implementation and allow time for questions/clarifications. Please see additional details under the Inpatient Per Diem Rate Meetings 2020 heading.

2019 Updates

Inpatient Per Diem Rate Meetings 2019

The next Inpatient Hospital Per Diem Reimbursement Meeting is set for Tuesday, June 25, 2019, 2.00pm - 3.00pm 

Webinar Link 

Conference Line: 1-877-820-7831 Passcode 294442#


News and Upcoming Dates 

  • Proposed Rule Update
  • Specialty Hospital Engagement Meetings


For questions regarding rates and their calculations please contact Andrew Abalos at


Related Links: Links to Inpatient Hospital Rates Page , Outpatient Hospital Rates Page and Hospital Stakeholder Engagement Page