The Frontier Psychiatrists

The Frontier Psychiatrists

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The Frontier Psychiatrists
The Frontier Psychiatrists
Inpatient Psychiatric Care is Paid Differently than All Other Hospital Care

Inpatient Psychiatric Care is Paid Differently than All Other Hospital Care

An APA Dispatch!

Owen Scott Muir, M.D, DFAACAP's avatar
Owen Scott Muir, M.D, DFAACAP
May 21, 2023
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The Frontier Psychiatrists
The Frontier Psychiatrists
Inpatient Psychiatric Care is Paid Differently than All Other Hospital Care
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Psychiatric hospital care and general medical hospital care are paid for in completely different ways. In fact, on the financial backend, there are even two different types of payment models for psychiatric hospitals.

In every other medical condition, the payment model follows the same basic principles: (the patient) may get a hospital bill, and it's got a bunch of line items, and it's for a phenomenal amount of money, and then it gets knocked down to this or that.

This is Live Action Role Playing on the part of Big Health.

The truth? This that's not how any of the actual bills from Medicare or other payers are paid. The bill you see is a legal truth and practical fiction… if you have insurance. The song and dance and $400 Tylenol are all there to obscure the fact that everything is paid differently:

  • Diagnosis-Related Group (DRG): Under the DRG system, patients are classified into groups based on primary ICD-10 diagnostic code, surgical procedures, age, etc. Each DRG group has a fixe…

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