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    v1.0.30
    OpenPayerBilling CodesFactors Influencing Health Status and Other Contacts with Health ServicesDRG 946-rehabilitation-without-cc-mcc
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    Rehabilitation without CC/MCC: Inpatient Reimbursement Overview

    DRG 946 applies to inpatient admissions driven by the need for intensive rehabilitation without Major Complication or Comorbidity or Complication or Comorbidity. It captures patients whose primary cost drivers are therapy and rehabilitation services, which influences Centers for Medicare & Medicaid Services payment classification and hospital reimbursement for post-acute recovery.

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    DRG 946 Overview

    DRG 946 covers inpatient stays primarily for intensive rehabilitation services when no Major Complication or Comorbidity or Complication or Comorbidity is present. Typical cases include medically stable patients admitted for multidisciplinary rehabilitative care after events such as stroke, orthopedic surgery, or neurological injury. This Diagnosis-Related Group groups patients by resource use focused on therapy intensity rather than acute medical complexity. It matters for Centers for Medicare & Medicaid Services payment because it defines inpatient reimbursement rates tied to rehabilitation-focused resource consumption.

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    Clinical Trials

    • Randomized comparative effectiveness studies of different therapist-led rehabilitation protocols (e.g., intensive inpatient physical therapy versus standard-duration therapy) for patients admitted for subacute functional decline after stroke, hip fracture, or deconditioning. These trials enroll typical DRG 946 patients who require skilled multidisciplinary rehabilitation but have no major complications, and they measure functional independence, length of stay, discharge disposition, and resource use. Results inform providers and payers about which therapy intensities or program compositions yield the best functional recovery per dollar spent, supporting efficient allocation of inpatient rehab resources and prospective payment planning.
    • Pragmatic trials testing multidisciplinary care pathway interventions that integrate mobility, swallowing, cognitive retraining, and caregiver training for older adults with multimorbidity undergoing inpatient rehabilitation. These studies focus on real-world populations common to DRG 946—frail elders and patients with combined physical and cognitive deficits—evaluating outcomes such as readmission rates, post-discharge functional status, and need for long-term care. Findings are relevant for clinicians and payers because optimized pathways can reduce inpatient length of stay and post-acute costs while improving discharge to home and reducing downstream utilization.
    • Post-discharge longitudinal outcomes and health services research tracking functional trajectories, quality of life, and health care utilization after discharge from inpatient rehabilitation among patients without major complications. Cohort studies or registry-based research follow DRG 946 patients to identify predictors of sustained recovery, outpatient therapy needs, and drivers of readmission or institutionalization over 6–12 months. This research helps payers and providers plan post-acute benefits, target transitional support services, and develop reimbursement models that align payment with long-term functional outcomes rather than only inpatient encounters.

    Related Codes

    939-O-R-PROCEDURES-WITH-DIAGNOSES-OF-OTHER-CONTACT-WITH-HEALTH-SERVICES-WITH-MCC

    O.R. Procedures with Diagnoses of Other Contact with Health Services with MCC: Inpatient Reimbursement Overview

    940-O-R-PROCEDURES-WITH-DIAGNOSES-OF-OTHER-CONTACT-WITH-HEALTH-SERVICES-WITH-CC

    O.R. Procedures with Diagnoses of Other Contact with Health Services with CC: Inpatient Reimbursement Overview

    941-O-R-PROCEDURES-WITH-DIAGNOSES-OF-OTHER-CONTACT-WITH-HEALTH-SERVICES-WITHOUT-CC-MCC

    O.R. Procedures with Diagnoses of Other Contact with Health Services without CC/MCC: Inpatient Reimbursement Overview

    945-REHABILITATION-WITH-CC-MCC

    Rehabilitation with CC/MCC: Inpatient Reimbursement Overview

    947-SIGNS-AND-SYMPTOMS-WITH-MCC

    Signs and Symptoms with Major Complication or Comorbidity: Inpatient Reimbursement Overview

    948-SIGNS-AND-SYMPTOMS-WITHOUT-MCC

    Signs and Symptoms without MCC: Inpatient Reimbursement Overview

    949-AFTERCARE-WITH-CC-MCC

    Aftercare with CC/MCC: Inpatient Reimbursement Overview

    950-AFTERCARE-WITHOUT-CC-MCC

    Aftercare without CC/MCC: Inpatient Reimbursement Overview

    951-OTHER-FACTORS-INFLUENCING-HEALTH-STATUS

    Other Factors Influencing Health Status: Inpatient Reimbursement Overview

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    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.