This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Psychiatry providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $153.72 | $76.43 | 2.01x | $77.29 | $493.9K | 7.9K | 2.5K |
| 2015 | $167.88 | $74.21 | 2.26x | $93.67 | $509.5K | 8.3K | 2.6K |
| 2016 | $167.31 | $75.87 | 2.21x | $91.44 | $523.7K | 8.5K | 2.5K |
| 2017 | $196.60 | $75.46 | 2.61x | $121.14 | $567.7K | 9.3K | 2.2K |
| 2018 | $198.10 | $70.71 | 2.80x | $127.39 | $402.2K | 6.6K | 2.2K |
| 2019 | $187.23 | $68.87 | 2.72x | $118.36 | $249.0K | 4.1K | 1.4K |
| 2020 | $134.65 | $72.89 | 1.85x | $61.76 | $233.4K | 3.8K | 1.3K |
| 2021 | $140.65 | $72.45 | 1.94x | $68.20 | $245.8K | 3.7K | 1.4K |
| 2022 | $152.46 | $74.79 | 2.04x | $77.67 | $162.7K | 2.7K | 865 |
| 2023 | $124.84 | $64.42 | 1.94x | $60.42 | $112.0K | 1.7K | 558 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 27.0K | $1.5M | $54.92 | 1.96x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.1K | $452.8K | $49.61 | 2.56x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.7K | $276.7K | $101.32 | 2.02x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.4K | $210.3K | $149.33 | 1.94x |
| 99238 | Hospital discharge day management, 30 minutes or less | 3.8K | $209.2K | $55.40 | 2.22x |
| 90870 | Shock treatment and monitoring | 2.1K | $180.6K | $84.12 | 2.18x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.0K | $153.0K | $76.31 | 2.04x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 1.8K | $139.7K | $75.90 | 1.94x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 1.4K | $96.3K | $69.29 | 2.17x |
| 90868 | Transcranial magnetic stimulation treatment (stimulates nerve cells in brain to improve symptoms of depression), per session | 844 | $89.2K | $105.74 | 3.79x |
| 99283 | Emergency department visit, moderately severe problem | 1.7K | $79.2K | $45.46 | 4.18x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 1.1K | $34.9K | $30.50 | 3.13x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 336 | $32.9K | $97.96 | 2.41x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 425 | $21.5K | $50.66 | 1.97x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 171 | $17.2K | $100.71 | 1.57x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 317 | $13.8K | $43.61 | 1.91x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 77 | $3.4K | $43.75 | 1.80x |
| 99325 | New patient assisted living visit, typically 30 minutes | 61 | $3.0K | $49.38 | 3.58x |
| 90867 | Transcranial magnetic stimulation treatment (stimulates nerve cells in brain to improve symptoms of depression) | 19 | $2.6K | $134.81 | 3.69x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 34 | $1.6K | $46.15 | 2.71x |
This provider submits charges 2.19 times higher than what Medicare actually pays.
A markup ratio of 2.19x means for every $100 Medicare pays, this provider initially charges $219. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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