DRG Outlier Additional Payment Amount

SAS Name
DRG_OUTLIER_AMT

The additional payment on a claim that is associated with either a cost outlier or length of stay outlier.

Comments

Outlier payments compensate hospitals paid on a fixed amount per "diagnosis related group" discharge with extra dollars for patient stays that substantially exceed the typical requirements for patient stays in the same DRG category.

SOURCE: T-MSIS Analytic File (TAF) Claims