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 |