WAC 296-23A-0200:

WACs > Title 296 > Chapter 296-23A > Section 296-23A-0200

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296-23A-0195 << 296-23A-0200 >> 296-23A-0210

PDFWAC 296-23A-0200

How does the department pay for hospital inpatient services?

The department will pay for hospital inpatient services according to the following table:

Hospital Type or Location	Do Diagnosis Related Group (DRG) payment methods apply?	Do per diem payment methods apply?	Do percent of allowed charges (POAC) payment methods apply to hospital inpatient services?
Children’s Hospitals	No	No	Yes, paid 100% of allowed charges
Chronic Pain Management Program	Exempt, paid per department agreement.	Exempt, paid per department agreement.	Exempt, paid per department agreement.
Health Maintenance Organizations	No	No	Yes, paid 100% of allowed charges
Military	No	No	Yes, paid 100% of allowed charges
Veterans Administration	No	No	Yes, paid 100% of allowed charges
State psychiatric facility	No	No	Yes, paid 100% of allowed charges
All other Washington hospitals	Yes	Yes, statewide average per diem rates apply for designated categories: Chemical dependency, psychiatric, rehabilitation, low volume medical, and low volume surgical DRGs	Yes, applies to low cost outlier payments and high cost outlier payments above the high cost outlier threshold

[Statutory Authority: RCW 51.04.030 and 51.12.330. WSR 06-12-073, § 296-23A-0200, filed 6/6/06, effective 7/7/06. Statutory Authority: RCW 51.04.020, 51.04.030, 51.36.080. WSR 00-06-027, § 296-23A-0200, filed 2/24/00, effective 3/26/00; WSR 97-06-066, § 296-23A-0200, filed 2/28/97, effective 4/1/97.]