Inpatient Psyche


Does anyone out there review inpatient psyche as part of their workflow? We are being asked to explore this and have done a small sample of reviews. We are finding minimal impacts of any kind, but we do not really understand how these are paid (for Medicare).

Does anyone have any experience or know where a resource may be imbedded on the ACDIS website?




  • Please review CMS Final Rule IPPS for Psychiatric Facilities.

  • Hello Linda, we do not review as those DRGs tend to hold tight without any changes due to secondary diagnoses. I did do some education on this topic and presented it to our executive team for Behavioral Health and the biggest opportunity was more of length of stay management.

  • We review adult inpatient psych, gero psych inpatient, and adolescent. The reviews are not as impactful for the medicare population because they are not billed by DRG but by days. That being said with our adult and adolescent floors it can make a large difference. We are looking for chronic conditions, nutrition status, withdrawal, medication induced encephalopathy, hallucinations in non-psychotic cases, specificity of Major depressive disorder etc. I am happy to help !

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