About Rates Batch Process

Periodically new and revised rates are released by the Centers for Medicare and Medicaid Services (CMS), other external sources, and North Dakota State staff. Rates are added and updated by a batch process. However, ND MMIS provides the capability to add and edit rates at any time, if necessary, using the Rates function in Rules Management. The batch process matches the rates from the update file to the existing rates on the Rate tables. If a rate exists on the update file, but is not present in ND MMIS, the record is added. If the rate exists in and the record is changed or deleted, it is updated accordingly.

Some of the interface files that may be received are:

• Medicare Physician Fee Schedule Relative Value (provided by CMS)
• Physician Fee Schedule Relative Value (provided by CMS)
• CLIA Lab Fee Schedule (provided by CMS)
• Medicare Fee Schedules (external source provides the file to the State)
• North Dakota Specific Diagnosis Related Group (DRG) Rate (State created file)
• North Dakota Specific Ambulatory Payment Classification (APC) Rate (State created file)
• Procedure Code Specific Rates (State created file)
• Revenue Code Specific Rates(State created file)

During the batch process, the Update Activity reports and Update Error reports are created for the various rates.

You can choose to run this batch process in non-update mode and review the reports before actually updating the system.

See Also

About Rates

About Rules Management

Version as of 5/16/14.