MS-DRG 895 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 | • Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
National average reimbursement for MS-DRG 895 by major payers:
$12,388.38
$19,770.53
$22,969.26
$22,622.47
| 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 895 | ||||||
United | 895 | $6034.00 | 1104447291 - PRIME HEALTHCARE SERVICES | 850737566 | CA | Psychiatric Hospital Unit (273R00000X) |
United | 895 | $10670.33 | 1952766263 - INDIANA REGIONAL MEDICAL CENTER | 250965404 - (PA) INDIANA REGIONAL MEDICAL CENTER | PA | Rural Acute Care Hospital (282NR1301X) |
United | 895 | $12350.50 | 1265651764 - J C BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON | 231352159 - (PA) J C BLAIR MEMORIAL HOSPITAL | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 895 | $20974.66 | 1548681091 - RCHP OTTUMWA LLC, SENIOR BEHAVIORAL CARE CENTER | 272200283 | IA | Psychiatric Hospital Unit (273R00000X) |
United | 895 | $25047.41 | 1457488595 - NEW LIBERTY HOSPITAL DISTRICT, LIBERTY HOSPITAL | 430977042 - (MO) NEW LIBERTY HOSPITAL DISTRICT | MO | General Acute Care Hospital (282N00000X) |
United | 895 | $26848.60 | 1043269798 - ST. CLOUD HOSPITAL | 410695596 - (MN) ST CLOUD HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | 895 | $29272.18 | 1184638942 - UPPER VALLEY MEDICAL CENTER | 310537095 - (OH) UPPER VALLEY MEDICAL CENTER | OH | General Acute Care Hospital (282N00000X) |
United | 895 | $10806.86 | 1427069632 - EDWARD HOSPITAL | 363297173 - (IL) EDWARD HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | 895 | $15774.04 | 1285227629 - SCRANTON HOSPITAL COMPANY LLC, REGIONAL HOSPITAL OF SCRANTON | 274564798 | PA | Medicare Defined Swing Bed Hospital Unit (275N00000X) |
United | 895 | $26765.88 | 1063442770 - HIALEAH HOSPITAL INC., HIALEAH HOSPITAL | 995053647 | FL | General Acute Care Hospital (282N00000X) |
United | 895 | $6965.00 | 1932122744 - HUNTERDON MEDICAL CENTER, HUNTERDON MEDICAL CENTER PSYCH | 221537688 - HUNTERDON MEDICAL CENTER | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 895 | $15677.86 | 1306816426 - ASCENSION MACOMB OAKLAND HOSPITAL, ST. JOHN MACOMB OAKLAND HOSPITAL-WARREN CAMPUS | 383322109 - ASCENSION MACOMB OAKLAND HOSPITAL | MI | Psychiatric Hospital Unit (273R00000X) |
United | 895 | $27277.25 | 1164029658 - PENN STATE HEALTH HAMPDEN MEDICAL CENTER | 851608328 - (PA) PENN STATE HEALTH HAMPDEN MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 895 | $7170.00 | 1922024835 - SOUTHCOAST HOSPITALS GROUP, INC, TOBEY HOSPITAL | 222592333 - SOUTHCOAST HOSPITALS GROUP INC | MA | General Acute Care Hospital (282N00000X) |
United | 895 | $34890.05 | 1518995505 - FOUNTAIN VALLEY REGIONAL HOSPITAL & MEDICAL CENTER, FOUNTAIN VALLEY REGIONAL HOSPITAL | 952768729 | CA | Psychiatric Hospital Unit (273R00000X) |
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 895 vs. Other Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders Codes
The MS-DRG 895 code is part of the Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders 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 895 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 |
|---|---|---|
| 894-APR-DRG | High | HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND |
| 894-MS-DRG | High | Alcohol, Drug Abuse or Dependence, Left AMA |
| 895-MS-DRG | High | Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy |
| 896-APR-DRG | Moderate | Major Cranial Or Facial Bone Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including MS-DRG 895. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 895 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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