MS-DRG 896 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 896 by major payers:
$13,502.60
$23,026.39
$28,074.64
$27,522.49
| 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 896 | ||||||
United | 896 | $23332.03 | 1902125529 - VHS WEST SUBURBAN MEDICAL CENTER INC | 611899386 | IL | General Acute Care Hospital (282N00000X) |
United | 896 | $4958.00 | 1033214440 - JOHNSTON MEMORIAL HOSPITAL, JOHNSTON MEMORIAL HOSPITAL ER PHYSICIANS | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | 896 | $22966.98 | 1255321436 - HOLY REDEEMER HEALTH SYSTEM, HRH TRANSITIONAL CARE UNIT | 231534300 - HOLY REDEEMER HEALTH SYSTEM | PA | Rehabilitation Hospital Unit (273Y00000X) |
United | 896 | $39306.12 | 1922139120 - INOVA HEALTH CARE SERVICES, INOVA MOUNT VERNON HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 896 | $23173.91 | 1497119218 - THEDACARE REGIONAL MEDICAL CENTER, APPLETON MEDICAL CENTER, INC. | 390824015 - (WI) THEDACARE REGIONAL MEDICAL CENTER- APPLETON INC | WI | General Acute Care Hospital (282N00000X) |
United | 896 | $5619.00 | 1194790055 - MARTIN MEMORIAL MEDICAL CENTER INC, MARTIN MEDICAL CENTER | 590637874 - MARTIN MEMORIAL MEDICAL CENTER INC | FL | General Acute Care Hospital (282N00000X) |
United | 896 | $24439.69 | 1659725901 - BBH PBMC, LLC, PRINCETON BAPTIST MEDICAL CENTER | 474775351 | AL | Psychiatric Hospital Unit (273R00000X) |
United | 896 | $23189.08 | 1275796856 - GEORGE COUNTY HOSPITAL, GREENE COUNTY HOSPITAL | 320222103 | MS | Critical Access Hospital (282NC0060X) |
United | 896 | $54447.96 | 1427618305 - UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | 841179794 - (CO) UNIVERSITY OF COLORADO HOSPITAL AUTHORITY | CO | General Acute Care Hospital (282N00000X) |
United | 896 | $20876.32 | 1033114608 - MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL, LLP, MEMORIAL HERMANN SURGICAL HOSPITAL FIRST COLONY | 352167462 - (TX) MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL LLP | TX | General Acute Care Hospital (282N00000X) |
United | 896 | $31002.73 | 1366545311 - SSM HEALTH CARE OF OKLAHOMA, INC., SSM HEALTH ST. ANTHONY HOSPITAL - OKLAHOMA CITY | 730657693 - SSM HEALTH CARE OF OKLAHOMA INC | OK | General Acute Care Hospital (282N00000X) |
United | 896 | $16395.83 | 1497830806 - DELTA HEALTH SYSTEM, DELTA HEALTH-THE MEDICAL CENTER | 640586958 - (MS) DELTA HEALTH SYSTEM | MS | Psychiatric Hospital Unit (273R00000X) |
United | 896 | $29752.15 | 1427103589 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER, CHERRY HILL | 910373400 - (WA) SWEDISH HEALTH SERVICES | WA | Rehabilitation Hospital Unit (273Y00000X) |
United | 896 | $5855.00 | 1891882833 - HILLCREST BAPTIST MEDICAL CENTER, BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | 741161944 - (TX) HILLCREST BAPTIST MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 896 | $65889.60 | 1578587986 - YORK HOSPITAL, WELLSPAN YORK HOSPITAL INPATIENT PSYCH UNIT | 231352222 - YORK HOSPITAL | PA | 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 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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