Manually enter CMS DRG provision factors

Use these instructions to add CMS DRG provision factors used when calculating Medicare Inpatient services.

To add CMS DRG factors to a provision:

  1. Navigate to the desired provision.

  2. On the Provisions page, in the CMS DRG column for the desired provision, click the Edit icon ().

  3. In the Edit Factors dialog, in the Settings tab, enter amounts in the fields provided, as needed.

    NOTE: Fields with names in blue indicate they are required for calculated payment. Fields with names preceded by a red percent sign (%) require you to enter the percentage amounts as decimals.

  4. If needed, assign transfer codes:
    1. Click the Transfer Codes tab.
    2. In the Available Codes section, locate the desired code in the list.
    3. On the right end of the list, click the Assign icon () to move the selected code to the Assigned Transfer Codes section.

  5. Do one of the following:

    • To save changes and keep working in the dialog, click Save.

    • To close the dialog after saving, click Save and Close.

    • To cancel your unsaved changes and close the dialog, click Close.

  6. If needed, add outlier exclusions.
See also