Manually enter provision factors for CMS calculations

Use these instructions to add CMS provision factors to APC contract versions.

To add factors to a provision:

  1. Navigate to the desired provision.

  2. In the Factors column, click the Set button (or, to modify a provision, click View).

  3. In the Factors window, click the tab that corresponds to the type of calculation (CMS DRG, CMS Psych, CMS CMG).

  4. In the desired CMS tab, enter amounts in the fields provided, as needed.

    NOTE: Fields with names followed by a red asterisk are required for calculated payment. Fields with names followed by a red cross require you to enter percentage amounts as decimals.

  5. If needed, select high-dollar outlier exclusions.
  6. Click Save, and then click Exit.
See also