CMS will be implementing Medicare Severity Diagnosis-Related Groups (MS-DRGs) effective October 1, 2007. HFN will also be implementing the MS-DRGs effective October 1, 2007 for those providers that currently have a DRG contract with HFN. Providers should begin billing with the MS-DRGs for claims with a discharge date on or after October 1, 2007.

For WC claims, providers with a DRG contract with HFN should begin billing with the MS-DRGs for claims with a discharge date on or after October 1, 2007. Providers that are contracted with HFN at a percentage of the Illinois state fee schedule should continue to bill with the old CMS-DRGs since the current Illinois state fee schedule is still based on the old CMS-DRGs.

Please contact our Network Management department at (800) 295-5444 if you have any questions regarding the transition to MS-DRGs.