---
kind: "section"
citation: "42 C.F.R. § 412.212"
title: "42"
number: "412.212"
heading: "National rate."
url: "https://uscodex.org/cfr/42/412.212"
---

# §412.212. National rate.

- (a) **General rule.** For purposes of payment to hospitals located in Puerto Rico, the national prospective payment rate for inpatient operating costs is determined as described in [paragraphs (b) through (d)](#b..d) of this section.
- (b) **Computing Puerto Rico standardized amounts.**
  - (1) **For Federal fiscal years before FY 2004, CMS computes a discharge-weighted average of the—**
    - (i) National urban adjusted standardized amount determined under [§ 412.63(j)(1)](/cfr/42/412.63.md?p=j-1); and
    - (ii) National rural adjusted average standardized amount determined under [§ 412.63(j)(2)(i)](/cfr/42/412.63.md?p=j-2-i).
  - (2) For fiscal years 2004 and subsequent fiscal years, CMS computes a discharge-weighted average of the national adjusted standardized amount determined under [§ 412.64(e)](/cfr/42/412.64.md?p=e).
- (c) **Computing a national rate.** For each discharge classified within a DRG, the national rate equals the product of—
  - (1) The national average standardized amount computed under [paragraph (b)](#b) of this section; and
  - (2) The weighting factor (determined under [§ 412.60(b)](/cfr/42/412.60.md?p=b)) for that DRG.
- (d) **Adjusting for different area wage levels.** CMS adjusts the proportion (as estimated by CMS from time to time) of the national rate computed under [paragraph (c)](#c) of this section that is attributable to wages and labor-related costs for area differences in hospital wage levels by a factor (established by CMS) reflecting the relative hospital wage level in the geographic area of the hospital compared to the national average hospital wage level.

## Notes

### Amendments

[52 FR 33058, Sept. 1, 1987, as amended at 53 FR 38533, Sept. 30, 1988; 57 FR 39825, Sept. 1, 1992; 69 FR 49248, Aug. 11, 2004]

### Source

Source: 52 FR 33058, Sept. 1, 1987, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Source

Source: 50 FR 12741, Mar. 29, 1985, unless otherwise noted.

### Amendments

[52 FR 33058, Sept. 1, 1987, as amended at 53 FR 38533, Sept. 30, 1988; 57 FR 39825, Sept. 1, 1992; 69 FR 49248, Aug. 11, 2004]