MS‑DRG 896: Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC
What Medicare paid hospitals for MS‑DRG 896 in 2024: nationally, state by state and across hospitals.
In 2024 Medicare paid hospitals an average of $15,247 per discharge for MS‑DRG 896, across 2,956 fee-for-service discharges at 188 hospitals: 0.06% of all Medicare inpatient discharges and $45.1M in total, the 200th largest MS‑DRG by Medicare spending.
By state, the average ran from $10,809 in Kentucky to $20,230 in Alaska. Across hospitals, half were paid between $12,243 and $16,711 per case, and the median hospital $14,295; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.
Hospitals charged $80,479 on average for these stays, 5.3 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 | 1.7451 | 1.6617 | −4.8% |
| Geometric mean stay (days) | 4.8 | 4.5 | −0.3 |
| Average stay (days) | 7.0 | 6.4 | −0.6 |
- Not capped: the −4.8% 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)
$12,276.56
The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.
| MS‑DRG | Severity | Payment ($) | Step ($) |
|---|---|---|---|
| 896 | with MCC | 12,276.56 | — |
| 897 | without MCC | 6,341.82 | −5,934.74 |
FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 896 at a hospital
Paid per case, by state
| State | Paid per case | Discharges | Hospitals | Charges ÷ paid |
|---|---|---|---|---|
| Maryland* | $20,986 | 49 | 4 | 1.2× |
| Alaska | $20,230 | 23 | 2 | 6.5× |
| New York | $19,888 | 222 | 15 | 6.4× |
| Idaho | $19,816 | 12 | 1 | 6.2× |
| California | $19,217 | 380 | 24 | 6.2× |
| Georgia | $19,055 | 26 | 2 | 3.8× |
| Connecticut | $17,220 | 96 | 6 | 3.5× |
| New Hampshire | $16,261 | 16 | 1 | 4.1× |
| Massachusetts | $16,101 | 399 | 17 | 2.7× |
| Rhode Island | $15,651 | 24 | 2 | 4.8× |
| Wyoming | $15,646 | 11 | 1 | 2.4× |
| Oregon | $15,388 | 26 | 2 | 2.5× |
| Wisconsin | $15,139 | 39 | 3 | 4.3× |
| New Jersey | $15,128 | 116 | 8 | 7.4× |
| Colorado | $15,104 | 49 | 4 | 5.4× |
| Minnesota | $14,669 | 168 | 12 | 4.2× |
| Nevada | $14,482 | 100 | 6 | 8.4× |
| Washington | $14,122 | 90 | 7 | 7.1× |
| Pennsylvania | $13,917 | 56 | 4 | 4.7× |
| Maine | $13,826 | 33 | 2 | 4.8× |
| Delaware | $13,527 | 33 | 1 | 3.1× |
| New Mexico | $13,157 | 41 | 2 | 3.3× |
| Nebraska | $13,009 | 23 | 2 | 4.0× |
| Ohio | $12,991 | 39 | 3 | 3.4× |
| North Dakota | $12,937 | 23 | 2 | 3.0× |
| Illinois | $12,719 | 105 | 7 | 4.9× |
| Michigan | $12,502 | 75 | 6 | 4.3× |
| Kansas | $12,403 | 24 | 2 | 8.9× |
| Texas | $12,291 | 77 | 5 | 6.3× |
| North Carolina | $12,252 | 54 | 3 | 4.9× |
| Missouri | $12,236 | 41 | 3 | 5.0× |
| South Carolina | $11,650 | 57 | 4 | 7.7× |
| Florida | $11,481 | 352 | 20 | 7.4× |
| Oklahoma | $11,434 | 33 | 2 | 3.4× |
| Indiana | $11,271 | 17 | 1 | 3.3× |
| Virginia | $10,978 | 11 | 1 | 23.4× |
| Kentucky | $10,809 | 16 | 1 | 5.8× |
| United States | $15,247 | 2,956 | 188 | 5.3× |
* Maryland hospitals are paid under the state’s all-payer model, not the IPPS, so Maryland is left out of the state range above.
How much hospitals vary
Each hospital’s own average Medicare payment for MS‑DRG 896.
| 10th percentile | $11,226 |
|---|---|
| 25th percentile | $12,243 |
| Median hospital | $14,295 |
| 75th percentile | $16,711 |
| 90th percentile | $19,906 |
Related analysis
The same condition at other severities
Nearby MS‑DRG numbers
Questions
What did Medicare pay for MS‑DRG 896 in 2024?
An average of $15,247 per discharge across 2,956 fee-for-service discharges at 188 hospitals, $45.1M in total.
Which state paid the most for MS‑DRG 896?
Alaska, at $20,230 per case; Kentucky paid the least, $10,809.
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.