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MS DRG Reimbursement Conversion for Hospitals in 2014

Blue Cross and Blue Shield of North Carolina (BCBSNC) began notifying participating hospitals in 2013 that payment methodology would be converted from AP-DRG to MS-DRG prior to October 1, 2014.

MS-DRG, used for Medicare reimbursement, is also widely used by many third-party payers.  This conversion will impact all hospitals currently with contracts that include AP-DRG or type-of-case reimbursement methodologies.  To ensure uninterrupted payment, all impacted hospitals must be converted to MS-DRG by October 1, 2014.

BCBSNC Network Management Contracting staff will be contacting each impacted hospital to discuss its respective conversion schedule.