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Coming Soon: TMHP to Implement APR-DRG Grouper 40 for Dates of Discharge on or After September 1, 2023

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Effective for dates of discharge on or after September 1, 2023, Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program will process inpatient claims in the All Patient Refined-Diagnosis Related Groups (APR-DRG) system using Grouper version 40 logic and relative weights and map to the International Classification of Diseases, Tenth Revision (ICD-10) version 40.1.

Note: The Grouper 40 implementation is not yet complete. Providers will be notified, and claims will be reprocessed retroactively to 9/1/2023 upon implementation.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.