{"data":{"id":"us-va/12vac30-70-231","jurisdiction":"us-va","citation":"12VAC30-70-231","heading":"Operating payment for DRG cases","body":"A. The operating payment for DRG cases that are not transfer cases shall be equal to the hospital specific operating rate per case, as determined in 12VAC30-70-311, times the DRG relative weight, as determined in 12VAC30-70-381.\n\nB. Exceptions.\n\n1. Special provisions for calculating the operating payment for transfer cases are provided in 12VAC30-70-251.\n\n2. Readmissions within five days of discharge shall be considered a continuation of the same stay and shall not be treated as a new case.\n\n3. Effective July 1, 2020, readmissions within six to 30 days of discharge shall be paid at 50% of the normal rate unless it is a planned readmission, an obstetrical readmission, an admission to critical access hospitals, or in any case where the patient was originally discharged against medical advice.","path":["Title 12. Health","Agency 30. Department of Medical Assistance Services","Chapter 70. Methods and Standards for Establishing Payment Rates; In-Patient Hospital Care","Part V. Inpatient Hospital Payment System","Article 2. Prospective (DRG-Based) Payment Methodology"],"source_url":"https://law.lis.virginia.gov/admincode/title12/agency30/chapter70/section231/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:50:58Z","sha256":"06d2d38bbdac66839092bb95fd6e26a89e836fe3e44a60db469006f3a7a1f546","source_id":"us-va-vac","stale":false,"prev":"us-va/12vac30-70-221","next":"us-va/12vac30-70-241"},"notice":"GroundRules: Original legal text. Not legal advice."}