<![CDATA[Abstract The payment for healthcare services in the National Health Insurance Program (Jaminan Kesehatan Nasional or JKN) conducted by the Health Social Security Agency (Badan Penyelenggara Jaminan Sosial Kesehatan or BPJS Kesehatan) to Advanced Referral Health Facilities (Fasilitas Kesehatan Rujukan Tingkat Lanjutan or FKRTL) uses the Indonesian Case Base Groups (INA-CBG) system. Based on the documentation study results in August 2023, the actual cost of the Intensive Care Unit (ICU) at the Dr. (H.C) Ir. Soekarno Regional General Hospital amounted to Rp. 478,713,649.00, while the INA-CBG claim tariff was Rp. 331,851,200.00. This indicates a negative difference of Rp. 146,862,449.00. The objective of this research is to determine the difference between the actual hospital tariff and the INA-CBG claim tariff for BPJS patients in the ICU at Dr. (H.C) Ir. Soekarno Regional General Hospital. The research method is quantitative, using analytical observational study design. The research results show a p-value of 0.019 < 0.05, indicating a difference between the actual hospital tariff and the INA-CBG claim tariff for BPJS patients in the ICU at Dr. (H.C) Ir. Soekarno Regional General Hospital. Conclutions: there are 65 patients with a negative difference (INA-CBG tariff < actual hospital tariff) and 45 patients with a positive difference (INA-CBG tariff > actual hospital tariff), totaling 110 patients. The difference between the actual hospital tariff and the INA-CBG tariff is Rp 1,213,895,735.00.]]>
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