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Disproportionate Share Adjustment (PI76)

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    Default Disproportionate Share Adjustment (PI76)
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    I have been seeing this adjustment recently and i have never come across it before. It has been only BCBS so far. I looked up the meaning of the ADJ and so I generally understand what it means. Has anyone else come across this ADJ and is there anything that can be done to reverse their decision? This ADJ is writing off the entire amount of our device checks when performed by our cardiologist in the office.

    Any insight is appreciated. Thanks!




    Disproportionate Share Adjustment
    A payment adjustment under Medicare’s PPS for Medicaid utilization at hospitals that serve a relatively large volume of low-income patients, pregnant patients or other patients under the Medicaid program. Disproportionate share has been a continuing topic in Congress. Some wish to eradicate to reduce costs. Rural facilities, teaching hospitals and hospitals in poverty areas claim that the reduction or elimination of disproportionate share payments would cause hospitals to close, move or reduce care to the poor. DSH is a method whereby the government recognizes that hospitals treating high percentages of Medicaid payments would not be able to cover their costs and remain in service without additional government subsidy.
    Last edited by carelitz; 09-18-2018 at 08:32 AM.

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