MS-DRG 099 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Diseases & Disorders of the Nervous System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 099 by major payers:
$16,299.99
$18,439.67
$21,851.91
$22,347.97
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for MS-DRG 099 | ||||||
United | 099 | $6141.00 | 1659538858 - PRIME HEALTHCARE SERVICES, GARDEN GROVE HOSPITAL & MEDICAL CENTER | 262583411 | CA | General Acute Care Hospital (282N00000X) |
United | 099 | $14557.20 | 1558391706 - RUSH OAK PARK HOSPITAL INC | 362183812 - (IL) RUSH OAK PARK HOSPITAL INC | IL | General Acute Care Hospital (282N00000X) |
United | 099 | $31017.64 | 1609957141 - CARONDELET HEALTH NETWORK, ST MARY'S HOSPITAL | 474131755 | AZ | Psychiatric Hospital Unit (273R00000X) |
United | 099 | $46511.14 | 1598864118 - NYU HOSPITALS CENTER | 133971298 - NYU LANGONE HOSPITALS | NY | General Acute Care Hospital (282N00000X) |
United | 099 | $31069.19 | 1801457510 - ADVENTHEALTH POLK NORTH INC, ADVENTHEALTH HEART OF FLORIDA | 841793121 | FL | General Acute Care Hospital (282N00000X) |
United | 099 | $19319.81 | 1629057229 - AHS HILLCREST MEDICAL CENTER, LLC, HILLCREST MEDICAL CENTER | 770633896 - (OK) AHS HILLCREST MEDICAL CENTER LLC | OK | General Acute Care Hospital (282N00000X) |
United | 099 | $27081.94 | 1346519816 - ST. JOSEPH'S HOSPITAL, INC., ST. JOSEPH'S WOMEN'S HOSPITAL | 592043026 - (FL) ST ANTHONYS HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 099 | $13974.79 | 1477531143 - VHS ACQUISITION SUBSIDIARY NUMBER 3 INC | 352637418 | IL | Psychiatric Hospital Unit (273R00000X) |
United | 099 | $15326.29 | 1710931985 - JEFFERSON HOSPITAL ASSOCIATION INC, JEFFERSON REGIONAL MEDICAL CENTER | 710329353 - (AR) JEFFERSON HOSPITAL ASSN INC | AR | General Acute Care Hospital (282N00000X) |
United | 099 | $33083.91 | 1326590852 - ST ELIZABETH MEDICAL CENTER INC, ST ELIZABETH HEALTHCARE GRANT SWING BED | 610445850 - ST ELIZABETH MEDICAL CENTER INC | KY | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 099 | $15902.00 | 1275763203 - MONTEFIORE MEDICAL CENTER | 131740114 - MONTEFIORE MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | 099 | $15316.54 | 1467537506 - CARONDELET HEALTH NETWORK, ST. MARY'S HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 099 | $19895.41 | 1114972007 - CANNON COUNTY HOSPITAL LLC, STONES RIVER HOSPITAL | 474063232 | TN | General Acute Care Hospital (282N00000X) |
United | 099 | $10420.62 | 1417941295 - UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER | 756001354 | TX | General Acute Care Hospital (282N00000X) |
United | 099 | $13275.36 | 1841740420 - SCHNECK MEDICAL CENTER | 351163135 - JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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MS-DRG 099 vs. Other Diseases & Disorders of the Nervous System Codes
The MS-DRG 099 code is part of the Diseases & Disorders of the Nervous System services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The MS-DRG 099 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 098-APR-DRG | High | OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES |
| 098-MS-DRG | High | Non-bacterial Infection of Nervous System except Viral Meningitis with CC |
| 099-MS-DRG | High | Non-bacterial Infection of Nervous System except Viral Meningitis without CC/MCC |
| 100-MS-DRG | High | Seizures with MCC |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 099. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 099 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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