Work comp: PC Pricer tool for inpatient hospital bills

Minnesota Statutes § 176.1362 provides that the maximum payment for most workers' compensation inpatient hospital services is 200% of the amount calculated under the Medicare diagnosis-related group (DRG) system.

For discharges on or after Oct. 1, 2021, payment for inpatient services, articles and supplies must be calculated using the inpatient PPS Web Pricer available on Medicare's website. Instructions for using the inpatient PPS Web Pricer are available below.

Additional information about inpatient hospital payments for Minnesota workers' compensation

• Spreadsheet:  Hospital provider identification numbers

• Statute:  Minnesota Statutes section 176.1362, Inpatient hospital payment

Hospital catastrophic injury threshold amounts

• Discharges from Oct. 1, 2024, through Sept. 30, 2025:  $314,423

• Discharges from Oct. 1, 2023, through Sept. 30, 2024:  $291,835

• Discharges from Oct. 1, 2022, through Sept. 30, 2023:  $268,774