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Fiscal Year 2004 DRG Weights and Rates for TRICARE Providers
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Table 1a - Adjusted Standardized Amounts for Large Urban and Other Areas and Cost Share Per Diem.
This table provides the adjusted standardized amounts and the cost-share per diem for beneficiaries other than dependents of active-duty members.The adjusted standardized amounts are effective for admissions occurring on or after November 1, 2003, through September 30, 2004.
The cost-share per diem is effective for inpatient days of care occurring on or after November 1, 2003, through September 30, 2004. Cost-share per diem for beneficiaries other than dependents of active duty members: $ 459.00
  Large Urban Other Areas
Adjusted Standardized Amount $ 3,916.13 $ 3,916.13
Labor Portion $ 2,784.37 $ 2,784.37
Non Labor Portion $ 1,131.76 $ 1,131.76
 
Table 1b - Adjusted Standardized Amounts for Large Urban and Other Areas and Cost Share Per Diem.
This table provides the adjusted standardized amounts and the cost-share per diem for beneficiaries other than dependents of active-duty members.The adjusted standardized amounts are effective for admissions occurring on or after October 1, 2003, through October 31, 2003.
The cost-share per diem is effective for inpatient days of care occurring on or after October 1, 2003, through October 31, 2003. Cost-share per diem for beneficiaries other than dependents of active duty members: $ 441.00
  Large Urban Other Areas
Adjusted Standardized Amount $ 3,916.13 $ 3,555.40
Labor Portion $ 2,784.37 $ 2,527.89
Non Labor Portion $ 1,131.76 $ 1,027.51
 
 
Table 2 - FY 2004 TRICARE/CHAMPUS DRG Weights and Threshold Summary
This table provides the final TRICARE/CHAMPUS DRG weights as well as the arithmetic and geometric average lengths of stay and outlier thresholds for all CHAMPUS DRGs. These amounts are effective for admissions on or after October 1, 2003, through September 30, 2004.
Notes:
  • * = low volume DRG with fewer than 10 cases. The Medicare weights and LOS are used for these DRGs.
  • # = PM-DRGs with fewer than 10 cases. An average weight over the past 5 years were used for these DRGs.
  • w cc = with Complications and Comorbidities.
  • w/o cc = without Complications or Comorbidities
  • To view DRG Weights click on the range of DRG numbers to see those records or select all to view all records.
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