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See a sample rate comparisonMS-DRG 896 Fee Schedule
Last Verified: October 2026
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.
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
| 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 896 by major payers:
$13,502.60
$23,026.39
$28,074.64
$27,522.49
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MS-DRG 896
5 of 25 sample ratesHigher to lower in this preview
York Hospital, Wellspan York Hospital Inpatient Psych Unit
York Hospital
$65,889.60Published rateWest Penn Allegheny Health System, Inc, Ahn Wexford Hospital
Highmark Health
$35,348.87Published rateVhs West Suburban Medical Center Inc
$23,332.03Published rateGenesis Health System, Genesis Medical Center Davenport
Genesis Health System
$19,380.44Published rateJohnston Memorial Hospital, Johnston Memorial Hospital Er Physicians
Johnston Memorial Hospital Inc
$4,958.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalMS-DRG 896 vs. Other Alcohol/Drug Use & Alcohol/Drug Induced Organic Mental Disorders Codes
The MS-DRG 896 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 896 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 |
|---|---|---|
| 895-MS-DRG | High | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY |
| 896-MS-DRG | High | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC |
| 897-APR-DRG | Moderate | Major Cranial Or Facial Bone Procedures |
| 897-MS-DRG | High | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT 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 896. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 896 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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