INPATIENT APRDRG 7501: SCHIZOPHRENIA
|
Facility
IP
|
$2,458.28
|
|
Service Code
|
APR-DRG 7501
|
Hospital Charge Code |
APRDRG 7501
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,458.28 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,458.28
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,458.28
|
|
INPATIENT APRDRG 7502: SCHIZOPHRENIA
|
Facility
IP
|
$2,789.38
|
|
Service Code
|
APR-DRG 7502
|
Hospital Charge Code |
APRDRG 7502
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,789.38 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,789.38
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,789.38
|
|
INPATIENT APRDRG 7503: SCHIZOPHRENIA
|
Facility
IP
|
$3,970.01
|
|
Service Code
|
APR-DRG 7503
|
Hospital Charge Code |
APRDRG 7503
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$3,970.01 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,970.01
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,970.01
|
|
INPATIENT APRDRG 7504: SCHIZOPHRENIA
|
Facility
IP
|
$8,601.59
|
|
Service Code
|
APR-DRG 7504
|
Hospital Charge Code |
APRDRG 7504
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$8,601.59 |
Rate for Payer: Buckeye Health Medicaid OOS |
$8,601.59
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$8,601.59
|
|
INPATIENT APRDRG 7511: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES
|
Facility
IP
|
$1,767.26
|
|
Service Code
|
APR-DRG 7511
|
Hospital Charge Code |
APRDRG 7511
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,767.26 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,767.26
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,767.26
|
|
INPATIENT APRDRG 7512: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES
|
Facility
IP
|
$2,127.50
|
|
Service Code
|
APR-DRG 7512
|
Hospital Charge Code |
APRDRG 7512
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,127.50 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,127.50
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,127.50
|
|
INPATIENT APRDRG 7513: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES
|
Facility
IP
|
$3,079.18
|
|
Service Code
|
APR-DRG 7513
|
Hospital Charge Code |
APRDRG 7513
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$3,079.18 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,079.18
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,079.18
|
|
INPATIENT APRDRG 7514: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES
|
Facility
IP
|
$5,455.81
|
|
Service Code
|
APR-DRG 7514
|
Hospital Charge Code |
APRDRG 7514
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$5,455.81 |
Rate for Payer: Buckeye Health Medicaid OOS |
$5,455.81
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$5,455.81
|
|
INPATIENT APRDRG 7521: DISORDERS OF PERSONALITY & IMPULSE CONTROL
|
Facility
IP
|
$1,686.57
|
|
Service Code
|
APR-DRG 7521
|
Hospital Charge Code |
APRDRG 7521
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,686.57 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,686.57
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,686.57
|
|
INPATIENT APRDRG 7522: DISORDERS OF PERSONALITY & IMPULSE CONTROL
|
Facility
IP
|
$1,766.30
|
|
Service Code
|
APR-DRG 7522
|
Hospital Charge Code |
APRDRG 7522
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,766.30 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,766.30
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,766.30
|
|
INPATIENT APRDRG 7523: DISORDERS OF PERSONALITY & IMPULSE CONTROL
|
Facility
IP
|
$2,112.13
|
|
Service Code
|
APR-DRG 7523
|
Hospital Charge Code |
APRDRG 7523
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,112.13 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,112.13
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,112.13
|
|
INPATIENT APRDRG 7524: DISORDERS OF PERSONALITY & IMPULSE CONTROL
|
Facility
IP
|
$2,112.13
|
|
Service Code
|
APR-DRG 7524
|
Hospital Charge Code |
APRDRG 7524
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,112.13 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,112.13
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,112.13
|
|
INPATIENT APRDRG 7531: BIPOLAR DISORDERS
|
Facility
IP
|
$1,868.45
|
|
Service Code
|
APR-DRG 7531
|
Hospital Charge Code |
APRDRG 7531
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,868.45 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,868.45
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,868.45
|
|
INPATIENT APRDRG 7532: BIPOLAR DISORDERS
|
Facility
IP
|
$2,194.75
|
|
Service Code
|
APR-DRG 7532
|
Hospital Charge Code |
APRDRG 7532
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,194.75 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,194.75
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,194.75
|
|
INPATIENT APRDRG 7533: BIPOLAR DISORDERS
|
Facility
IP
|
$2,917.47
|
|
Service Code
|
APR-DRG 7533
|
Hospital Charge Code |
APRDRG 7533
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,917.47 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,917.47
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,917.47
|
|
INPATIENT APRDRG 7534: BIPOLAR DISORDERS
|
Facility
IP
|
$5,864.72
|
|
Service Code
|
APR-DRG 7534
|
Hospital Charge Code |
APRDRG 7534
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$5,864.72 |
Rate for Payer: Buckeye Health Medicaid OOS |
$5,864.72
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$5,864.72
|
|
INPATIENT APRDRG 7541: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER
|
Facility
IP
|
$1,691.69
|
|
Service Code
|
APR-DRG 7541
|
Hospital Charge Code |
APRDRG 7541
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,691.69 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,691.69
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,691.69
|
|
INPATIENT APRDRG 7542: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER
|
Facility
IP
|
$2,234.77
|
|
Service Code
|
APR-DRG 7542
|
Hospital Charge Code |
APRDRG 7542
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,234.77 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,234.77
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,234.77
|
|
INPATIENT APRDRG 7543: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER
|
Facility
IP
|
$2,882.57
|
|
Service Code
|
APR-DRG 7543
|
Hospital Charge Code |
APRDRG 7543
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,882.57 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,882.57
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,882.57
|
|
INPATIENT APRDRG 7544: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER
|
Facility
IP
|
$2,882.57
|
|
Service Code
|
APR-DRG 7544
|
Hospital Charge Code |
APRDRG 7544
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,882.57 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,882.57
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,882.57
|
|
INPATIENT APRDRG 7551: ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES
|
Facility
IP
|
$1,545.67
|
|
Service Code
|
APR-DRG 7551
|
Hospital Charge Code |
APRDRG 7551
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$1,545.67 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,545.67
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,545.67
|
|
INPATIENT APRDRG 7552: ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES
|
Facility
IP
|
$2,396.16
|
|
Service Code
|
APR-DRG 7552
|
Hospital Charge Code |
APRDRG 7552
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,396.16 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,396.16
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,396.16
|
|
INPATIENT APRDRG 7553: ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES
|
Facility
IP
|
$3,344.32
|
|
Service Code
|
APR-DRG 7553
|
Hospital Charge Code |
APRDRG 7553
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$3,344.32 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,344.32
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,344.32
|
|
INPATIENT APRDRG 7554: ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES
|
Facility
IP
|
$3,344.32
|
|
Service Code
|
APR-DRG 7554
|
Hospital Charge Code |
APRDRG 7554
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$3,344.32 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,344.32
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,344.32
|
|
INPATIENT APRDRG 7561: ACUTE ANXIETY & DELIRIUM STATES
|
Facility
IP
|
$2,002.30
|
|
Service Code
|
APR-DRG 7561
|
Hospital Charge Code |
APRDRG 7561
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,002.30 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,002.30
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,002.30
|
|