MS‑DRG 895: Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy
What Medicare paid hospitals for MS‑DRG 895 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $12,280 per discharge for MS‑DRG 895, across 3,333 fee-for-service discharges at 53 hospitals: 0.07% of all Medicare inpatient discharges and $40.9M in total, the 207th largest MS‑DRG by Medicare spending.
By state, the average ran from $9,010 in Utah to $16,288 in Florida. Across hospitals, half were paid between $11,123 and $13,778 per case, and the median hospital $12,513; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $33,903 on average for these stays, 2.8 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.
What changed in FY2027
The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.
| FY2026 | FY2027 | Change | |
|---|---|---|---|
| Relative weight | 1.4156 | 1.4266 | +0.8% |
| Geometric mean stay (days) | 7.2 | 7.5 | +0.3 |
| Average stay (days) | 10.3 | 10.7 | +0.4 |
- Not capped: the +0.8% is CMS’s yearly recalibration of every weight from recent claims and cost data.
- Name, MDC and transfer status are unchanged.
FY2027 national base payment (illustration)
$10,539.65
The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 895 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Florida | $16,288 | 50 | 1 | 2.2× |
| California | $15,199 | 263 | 5 | 2.0× |
| New Jersey | $13,765 | 81 | 3 | 4.6× |
| New York | $13,646 | 532 | 18 | 6.3× |
| Nevada | $13,541 | 19 | 1 | 2.6× |
| Massachusetts | $13,292 | 816 | 4 | 1.2× |
| Texas | $12,233 | 286 | 2 | 1.9× |
| Washington | $12,119 | 13 | 1 | 2.9× |
| Illinois | $11,781 | 81 | 2 | 3.5× |
| Ohio | $11,753 | 76 | 1 | 3.2× |
| Colorado | $11,494 | 11 | 1 | 3.9× |
| Alabama | $11,225 | 127 | 4 | 1.1× |
| Minnesota | $11,040 | 15 | 1 | 5.3× |
| Pennsylvania | $10,908 | 207 | 2 | 4.1× |
| Wisconsin | $10,711 | 13 | 1 | 1.0× |
| Indiana | $10,418 | 45 | 1 | 1.2× |
| Kentucky | $10,317 | 41 | 1 | 1.5× |
| Tennessee | $9,960 | 23 | 1 | 5.4× |
| Georgia | $9,409 | 448 | 1 | 1.5× |
| Michigan | $9,067 | 156 | 1 | 1.7× |
| Utah | $9,010 | 30 | 1 | 7.0× |
| United States | $12,280 | 3,333 | 53 | 2.8× |
How much hospitals vary
Each hospital’s own average Medicare payment for MS‑DRG 895.
| 10th percentile | $9,809 |
|---|---|
| 25th percentile | $11,123 |
| Median hospital | $12,513 |
| 75th percentile | $13,778 |
| 90th percentile | $16,247 |
The same condition at other severities
Nearby MS‑DRG numbers
Questions
What did Medicare pay for MS‑DRG 895 in 2024?
An average of $12,280 per discharge across 3,333 fee-for-service discharges at 53 hospitals, $40.9M in total.
Which state paid the most for MS‑DRG 895?
Florida, at $16,288 per case; Utah paid the least, $9,010.
Where do these figures come from?
From the Medicare Inpatient Hospitals - by Provider and Service (data year 2024): the published hospital-by-DRG averages of Medicare fee-for-service inpatient discharges in 2024. Cells with fewer than 11 discharges are not published, so a hospital with a handful of cases is not counted. Average Medicare payment excludes the patient’s deductible and coinsurance.