Re: rugg rates

[KDeniseSRN]

Can you manually correct your UB92 to bill the higher $$$ RUG rate, in this case the SE3 in place of the RHC?   People I know are being told both ways Yes & No   As always thank you. Determination of RUG level is based on highest case-mix index, not highest dollars unfortunately.  They used to be one and the same before the percentage add-ons, but not currently.  So, you can qualify for both SE3 (higher $, CMI 1.590) and RHC (lower $, CMI 1.640), and will get paid for RHC.  So, if you want SE3, you generally have to pick an early ARD to eliminate the "projection factor" unless the projection is for less than 8 days.  If your software isn't selecting the highest CMI, you have a problem...