[01]
Severity level 3 → 4
Severity levels increase from 3 to 4 (0, I, II, III), demanding more accurate severity assignment.
[Regulatory Guide] iDRG Casemix
From INA-CBG to iDRG.
JKN casemix is moving from INA-CBG to iDRG. We explain what changes and how to prepare your system — honestly: as of 2026 there is no official national go-live, so we do not invent dates.
Background
Casemix is moving — but the date is not yet certain.
iDRG (Indonesian Diagnosis-Related Groups) is being positioned as the successor to INA-CBG as the basis for JKN casemix tariffs. Trials of the new grouper have been running since around October 2025, but as of 2026 there is no official national go-live date; the transition may proceed in phases or as dual-running.
That is why this page does not sell schedule certainty. Its focus: what changes, and the preparation that is useful whatever the final date turns out to be.
What changes
Four key changes.
The gist: tariffs depend increasingly on clinical accuracy and documentation completeness — no longer just on ward class.
[02]
Higher DRG granularity
More detailed grouping — tariffs depend increasingly on the accuracy of diagnosis, procedure, and severity.
[03]
More detailed CC/MCC documentation
Requires complete, consistent recording of complications & comorbidities (CC) and major CC (MCC) in the medical record.
[04]
Removing the ward-class variable
iDRG is designed to no longer separate tariffs by hospital class and ward class, but to base them on clinical factors & facility competency instead.
- Strengthen the quality and completeness of clinical documentation (especially CC/MCC)
- Tighten ICD-10/ICD-9-CM coding discipline as the foundation of both schemes
- Build an internal claim-audit routine to catch gaps earlier
- Ensure the claims system can adapt to the new grouper format once the rules are finalized
Adievia's role: an E-Klaim module with a grouper and a fault-tolerant outbox queue, built to adapt to a new grouper format once the rules are finalized. What we can guarantee now is the foundation — not a claim of "full iDRG readiness" before the provisions are issued.
FAQ
Questions about the iDRG transition.
iDRG (Indonesian Diagnosis-Related Groups) is the successor to INA-CBG as the basis for JKN (national health insurance) casemix tariffs. As of 2026, iDRG is still in a phased transition and no official national go-live date has been announced. Trials of the new grouper have been running since around October 2025, heading toward a phased rollout. We do not invent dates.
Several highlighted changes: severity levels increase from 3 to 4, grouping granularity is higher, documentation of complications and comorbidities (CC/MCC) becomes more detailed, and there is a move to remove tariff differentiation by hospital class and ward class toward clinical-based parity.
Because the exact date has not been set, the safest step is to fix what stays relevant in both schemes: clinical documentation quality (especially CC/MCC), ICD-10/ICD-9-CM coding discipline, and an internal claim-audit routine. This is an investment that is not wasted, whatever the timeline turns out to be.
Adievia's E-Klaim module is built with a grouper and a fault-tolerant outbox queue. This foundation — clean coding plus an architecture designed to adapt to a new grouper format — is what we can guarantee now, without promising "full iDRG" readiness before the rules are finalized.
Next step