Depressive Neuroses DRG Reimbursement & Medicare Rates

Summary & Overview

Depressive Neuroses: Inpatient Reimbursement Overview

DRG 881 encompasses inpatient cases with principal diagnoses of depressive neuroses, representing depressive disorders that require hospital-level care for stabilization, monitoring, or intensive treatment. It matters for inpatient reimbursement because Diagnosis-Related Group assignment drives Medicare prospective payment and reflects clinical severity and resource needs of the admission.

Depressive NeurosesDRG Depressive NeurosesDRG 881Diagnosis-Related GroupInpatient ReimbursementMedicarePsychiatryBehavioral HealthInpatient PsychiatryMental Health Coding

DRG 881 Overview

DRG 881 covers hospital inpatient stays primarily for depressive neuroses, including a range of depressive disorders treated when the principal diagnosis leads to inpatient care. This Diagnosis-Related Group groups patients by clinical similarity and expected resource use for Medicare payment purposes. It matters for Medicare payment because assignment to this Diagnosis-Related Group determines the prospective payment rate for the inpatient stay. Clinical documentation and coding of the principal diagnosis, comorbidities, and severity affect reimbursement within the inpatient prospective payment system.

National Payment Rates

Across national payers the allowed rate distribution for DRG 881 ranges from approximately $370 up to $24K, with payer medians spanning roughly $2.1K to $15K depending on the insurer. The widest spread is between the lowest observed value ($370) and the highest ($24K). See the table and chart below for payer-level percentiles and distribution details.

Mean Rates by Payer — National — DRG 881

The CMS 2023 data represent national Medicare fee-for-service inpatient payments reported under the CMS Provider Utilization and Payment Data program. The table below shows average total payment ($8.8k), average submitted covered charges ($29.3k), average Medicare payment ($7.0k), and total discharges (2.2k).

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Alaska’s DRG 881 payments vary from roughly $2.5K up to $26K across the payers reported, with Anthem showing the lowest median ($11K) and Cigna the highest median ($15K). BCBS has a median of $15K but a lower p25 than Cigna, producing asymmetric distribution across payers. Overall, Alaska’s medians for Cigna and BCBS sit at or above national medians while Anthem is notably below; see the table and chart below for full distribution detail.

Key Insights for Alaska

Highest payer: Cigna (median $15K; p75 $22K) — highest central tendency among listed payers. Lowest payer: Anthem (median $11K; p25 $6.2K) — lowest median and lower quartile.
Alaska’s payer range spans roughly $2.5K to $26K across payers, with Cigna and BCBS medians above national median levels while Anthem’s median sits below national benchmarks.

Clinical Trials

Acute pharmacologic and rapid-acting intervention trials: These studies evaluate short-term efficacy and safety of rapid-onset antidepressant strategies (e.g., intravenous or intranasal formulations and adjunctive agents) in hospitalized adults presenting with severe depressive symptoms, suicidal ideation, or treatment-resistant features that precipitated inpatient care. The patient population is typically medically stabilized inpatients with major depressive episodes or severe depressive neuroses who need fast symptom relief to reduce inpatient length of stay and immediate risk. Research is relevant to providers and payers because evidence about speed of symptom reduction, safety in medically comorbid inpatients, and impact on discharge timing can affect inpatient resource utilization and reimbursement decisions.
Comparative effectiveness and care-pathway studies in inpatient psychiatric units: These trials compare different evidence-based treatment approaches (for example, structured psychotherapy initiation versus medication optimization, or combined modalities versus single-modality care) among adults admitted for depressive neuroses to determine which care pathways produce better short-term functional improvement and lower readmission rates. The population studied includes diverse inpatients with depressive syndromes, often with comorbid anxiety or substance use, and the question is which organized inpatient treatment bundles lead to optimal stabilization and transition to outpatient care. Findings inform clinicians and payers about which inpatient service models and staffing configurations yield better outcomes and potential cost savings through reduced length of stay and readmissions.
Post-discharge transitional care and outcomes trials: These prospective studies test interventions delivered around discharge—such as enhanced care coordination, structured follow-up, telehealth check-ins, or stepped-care outpatient programs—to reduce relapse, emergency visits, and 30- to 90-day readmissions among patients hospitalized for depressive neuroses. The focus population is recently discharged inpatients at high risk for poor continuity of care, medication nonadherence, or suicide risk, and the research measures downstream utilization, symptom trajectory, and functional recovery. This area is critical for payers and providers because improved transitional interventions can lower avoidable readmissions and emergency utilization, inform bundled-payment models, and guide allocation of outpatient resources after an inpatient stay.

Related Codes

882-NEUROSES-EXCEPT-DEPRESSIVE

Neuroses Except Depressive: Inpatient Reimbursement Overview

876-O-R-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-OF-MENTAL-ILLNESS

O.R. Procedures with Principal Diagnosis of Mental Illness: Inpatient Reimbursement Overview

886-BEHAVIORAL-AND-DEVELOPMENTAL-DISORDERS

Behavioral and Developmental Disorders: Inpatient Reimbursement Overview

883-DISORDERS-OF-PERSONALITY-AND-IMPULSE-CONTROL

Disorders of Personality and Impulse Control: Inpatient Reimbursement Overview

880-ACUTE-ADJUSTMENT-REACTION-AND-PSYCHOSOCIAL-DYSFUNCTION

Acute Adjustment Reaction and Psychosocial Dysfunction: Inpatient Reimbursement Overview

885-PSYCHOSES

Psychoses: Inpatient Reimbursement Overview

884-ORGANIC-DISTURBANCES-AND-INTELLECTUAL-DISABILITY

Organic Disturbances and Intellectual Disability: Inpatient Reimbursement Overview

887-OTHER-MENTAL-DISORDER-DIAGNOSES

Other Mental Disorder Diagnoses: Inpatient Reimbursement Overview

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Average Total Payment	Average Submitted Charges	Average Medicare Payment	Total Discharges
$8.8K	$29K	$7K	2.2K

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 881

Key Insights for Alaska

Highest payer: Cigna (median $15K; p75 $22K) — highest central tendency among listed payers. Lowest payer: Anthem (median $11K; p25 $6.2K) — lowest median and lower quartile.
Alaska’s payer range spans roughly $2.5K to $26K across payers, with Cigna and BCBS medians above national median levels while Anthem’s median sits below national benchmarks.

Clinical Trials

Acute pharmacologic and rapid-acting intervention trials: These studies evaluate short-term efficacy and safety of rapid-onset antidepressant strategies (e.g., intravenous or intranasal formulations and adjunctive agents) in hospitalized adults presenting with severe depressive symptoms, suicidal ideation, or treatment-resistant features that precipitated inpatient care. The patient population is typically medically stabilized inpatients with major depressive episodes or severe depressive neuroses who need fast symptom relief to reduce inpatient length of stay and immediate risk. Research is relevant to providers and payers because evidence about speed of symptom reduction, safety in medically comorbid inpatients, and impact on discharge timing can affect inpatient resource utilization and reimbursement decisions.
Comparative effectiveness and care-pathway studies in inpatient psychiatric units: These trials compare different evidence-based treatment approaches (for example, structured psychotherapy initiation versus medication optimization, or combined modalities versus single-modality care) among adults admitted for depressive neuroses to determine which care pathways produce better short-term functional improvement and lower readmission rates. The population studied includes diverse inpatients with depressive syndromes, often with comorbid anxiety or substance use, and the question is which organized inpatient treatment bundles lead to optimal stabilization and transition to outpatient care. Findings inform clinicians and payers about which inpatient service models and staffing configurations yield better outcomes and potential cost savings through reduced length of stay and readmissions.
Post-discharge transitional care and outcomes trials: These prospective studies test interventions delivered around discharge—such as enhanced care coordination, structured follow-up, telehealth check-ins, or stepped-care outpatient programs—to reduce relapse, emergency visits, and 30- to 90-day readmissions among patients hospitalized for depressive neuroses. The focus population is recently discharged inpatients at high risk for poor continuity of care, medication nonadherence, or suicide risk, and the research measures downstream utilization, symptom trajectory, and functional recovery. This area is critical for payers and providers because improved transitional interventions can lower avoidable readmissions and emergency utilization, inform bundled-payment models, and guide allocation of outpatient resources after an inpatient stay.