Other Mental Disorder Diagnoses DRG Reimbursement Rates

Summary & Overview

Other Mental Disorder Diagnoses: Inpatient Reimbursement Overview

DRG 887 encompasses inpatient stays for other mental disorder diagnoses involving non-specific or miscellaneous psychiatric conditions and related resource use. Assignment to this Diagnosis-Related Group affects Medicare payment by setting the bundled inpatient reimbursement tied to the clinical profile and documented complications or comorbidities.

Other Mental Disorder DiagnosesDRG Other Mental Disorder DiagnosesDRG 887Diagnosis-Related GroupInpatient ReimbursementMedicarePsychiatryBehavioral HealthPsychiatric EvaluationMedication Management

DRG 887 Overview

DRG 887 covers inpatient admissions for other mental disorder diagnoses that do not fit into specific major psychiatric groups, including various nonpsychotic and miscellaneous psychiatric conditions. This Diagnosis-Related Group captures resource use associated with psychiatric evaluation, monitoring, medication management, and supportive care in the acute hospital setting. It matters for Medicare payment because assignment to DRG 887 determines the prospective bundled payment for the entire inpatient stay and reflects clinical complexity when Major Complication or Comorbidity or Complication or Comorbidity are absent. Accurate coding of primary and secondary psychiatric diagnoses influences reimbursement and hospital case mix.

National Payment Rates

Across commercial payers the observed rate range spans from about $4K to $29K, with payer medians clustering between roughly $2K and $17K depending on the insurer; the widest spread is between Cigna (max $29K) and Anthem (median $3.3K) as shown in the table and chart below. Insurers vary considerably, with Aetna and Cigna on the higher end of observed maxima and Anthem and BCBS showing lower medians. Refer to the table and chart below for payer-specific distributions.

Mean Rates by Payer — National — DRG 887

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Payer medians in Alaska for DRG 887 range from $12K (Anthem / Blue Cross Blue Shield) up to $17K (Cigna), with mean values clustering between $14K and $20K across payers. The Alaska distribution skews substantially higher than national medians for Anthem and BCBS, representing the most notable deviation from national averages. See the table and chart below for payer-specific percentiles and spread.

Key Insights for Alaska

Anthem and Blue Cross Blue Shield provide the lowest median reimbursement in Alaska (median $12K), while Cigna offers the highest median reimbursement (median $17K).
Alaska’s payer medians (range $12K–$17K) sit substantially above national medians for the same payers (national medians roughly $3.3K for Anthem/BCBS and $12K–$17K for Cigna/Aetna), indicating notably higher regional rates; Anthem/BCBS in Alaska are especially elevated versus their national averages.

Clinical Trials

Acute management trials assessing rapid stabilization strategies for patients admitted with severe but non-specific psychiatric presentations (e.g., acute agitation, severe depressive episodes not meeting single-diagnosis criteria, acute psychosis of unclear etiology). These studies enroll inpatients in emergency or psychiatric units to compare short-term behavioral or pharmacologic approaches, safety protocols, and crisis-intervention algorithms aimed at reducing need for restraints, length of stay, and early readmission. Findings are relevant to providers for optimizing initial inpatient care pathways and to payers because acute stabilization directly drives inpatient resource utilization and short-term costs.
Comparative effectiveness studies evaluating diagnostic and treatment pathways for heterogeneous mental disorders grouped under this DRG, such as trials comparing structured diagnostic assessments plus stepped-care algorithms versus usual care in hospitalized adults with complex or comorbid psychiatric symptoms. These trials focus on patients whose presentations do not fit a single classic DSM category, assessing outcomes like diagnostic clarity, appropriate medication changes, functional status at discharge, and 30- to 90-day readmission rates. Results inform providers about which care models improve clinical decision-making and discharge planning, and inform payers about which approaches reduce inappropriate inpatient days and downstream utilization.
Post-discharge outcomes and care-transition studies testing interventions to reduce relapse and readmission among patients discharged with non-specific or mixed mental disorder diagnoses, for example randomized or pragmatic trials of intensive community follow-up, telehealth case management, or social service integration versus standard outpatient referral. These studies enroll recently discharged inpatients with complex psychosocial needs, substance use comorbidity, or uncertain outpatient plans, measuring metrics such as time to first readmission, emergency visits, adherence to outpatient appointments, and functional recovery over 6–12 months. This research is relevant to providers managing discharge planning and continuity of care and to payers focused on lowering readmission rates and total cost of care by identifying effective post-discharge supports.

Related Codes

885-PSYCHOSES

Psychoses: Inpatient Reimbursement Overview

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

Acute Adjustment Reaction and Psychosocial Dysfunction: Inpatient Reimbursement Overview

886-BEHAVIORAL-AND-DEVELOPMENTAL-DISORDERS

Behavioral and Developmental Disorders: Inpatient Reimbursement Overview

884-ORGANIC-DISTURBANCES-AND-INTELLECTUAL-DISABILITY

Organic Disturbances and Intellectual Disability: Inpatient Reimbursement Overview

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

Disorders of Personality and Impulse Control: 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

881-DEPRESSIVE-NEUROSES

Depressive Neuroses: Inpatient Reimbursement Overview

882-NEUROSES-EXCEPT-DEPRESSIVE

Neuroses Except Depressive: 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
$12K	$50K	$10K	310

State Payment Rates

State: Alaska1 / 49

Alaska Benchmarks

Mean Rates by Payer — Alaska — DRG 887

Key Insights for Alaska

Anthem and Blue Cross Blue Shield provide the lowest median reimbursement in Alaska (median $12K), while Cigna offers the highest median reimbursement (median $17K).
Alaska’s payer medians (range $12K–$17K) sit substantially above national medians for the same payers (national medians roughly $3.3K for Anthem/BCBS and $12K–$17K for Cigna/Aetna), indicating notably higher regional rates; Anthem/BCBS in Alaska are especially elevated versus their national averages.

Clinical Trials

Acute management trials assessing rapid stabilization strategies for patients admitted with severe but non-specific psychiatric presentations (e.g., acute agitation, severe depressive episodes not meeting single-diagnosis criteria, acute psychosis of unclear etiology). These studies enroll inpatients in emergency or psychiatric units to compare short-term behavioral or pharmacologic approaches, safety protocols, and crisis-intervention algorithms aimed at reducing need for restraints, length of stay, and early readmission. Findings are relevant to providers for optimizing initial inpatient care pathways and to payers because acute stabilization directly drives inpatient resource utilization and short-term costs.
Comparative effectiveness studies evaluating diagnostic and treatment pathways for heterogeneous mental disorders grouped under this DRG, such as trials comparing structured diagnostic assessments plus stepped-care algorithms versus usual care in hospitalized adults with complex or comorbid psychiatric symptoms. These trials focus on patients whose presentations do not fit a single classic DSM category, assessing outcomes like diagnostic clarity, appropriate medication changes, functional status at discharge, and 30- to 90-day readmission rates. Results inform providers about which care models improve clinical decision-making and discharge planning, and inform payers about which approaches reduce inappropriate inpatient days and downstream utilization.
Post-discharge outcomes and care-transition studies testing interventions to reduce relapse and readmission among patients discharged with non-specific or mixed mental disorder diagnoses, for example randomized or pragmatic trials of intensive community follow-up, telehealth case management, or social service integration versus standard outpatient referral. These studies enroll recently discharged inpatients with complex psychosocial needs, substance use comorbidity, or uncertain outpatient plans, measuring metrics such as time to first readmission, emergency visits, adherence to outpatient appointments, and functional recovery over 6–12 months. This research is relevant to providers managing discharge planning and continuity of care and to payers focused on lowering readmission rates and total cost of care by identifying effective post-discharge supports.