For services provided on or
after April 1, 2018, the non-professional component or facility
component of the birthing center all-inclusive rate is now the one-day
Diagnosis Related Group (DRG) Short-Stay Outlier (SSO) for DRG 775
(uncomplicated vaginal birth) adjusted for geographic cost variations.
Since DRG 775 has been deleted by the Centers for Medicare and Medicaid
Services (CMS) starting in Fiscal Year (FY) 2019, Defense Health
Agency (DHA) is replacing DRG 775 with the one-day SSO for DRG 807
(uncomplicated vaginal birth without sterilization/D&C) adjusted
for geographic cost variations, effective for service dates on or
after October 1, 2018. The DRG ZIP-to-wage index files shall be
used for adjusting the facility component rate for geographical
labor cost variations. The FY 2018 and FY 2019 DRG rates are available
on the DRG Rates page of the Military Health System (MHS) website
at
https://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Diagnosis-Related-Group-Rates. The
birthing center rates information for subsequent future FYs will
no longer be published in this manual (Chapter 10, Addendum A) since
the rates are located on the DRG Rates page of the MHS website.