ReimbursementQuestion 70 of 100
Diagnosis-Related Groups (DRGs) are used mainly to determine reimbursement for:
a.Physician office visits
b.Outpatient laboratory tests
c.Retail prescription drugs
d.Inpatient hospital stays, by grouping cases with similar clinical characteristics and resource use
Explanation
DRGs classify inpatient admissions into groups that are expected to consume similar hospital resources, and each group carries a fixed payment weight. This prospective payment method pays a set amount per admission rather than per service. It creates an incentive for efficient inpatient care.
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