This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Geriatric 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 | $140.64 | $60.21 | 2.34x | $80.43 | $673.8K | 14.7K | 2.9K |
| 2015 | $140.00 | $61.08 | 2.29x | $78.92 | $633.1K | 13.7K | 2.7K |
| 2016 | $133.37 | $58.11 | 2.30x | $75.26 | $422.0K | 9.1K | 1.9K |
| 2017 | $133.25 | $56.58 | 2.36x | $76.67 | $337.7K | 7.4K | 1.4K |
| 2018 | $133.32 | $60.20 | 2.21x | $73.12 | $493.4K | 10.4K | 1.8K |
| 2019 | $128.57 | $63.57 | 2.02x | $65.00 | $485.0K | 9.9K | 1.8K |
| 2020 | $132.34 | $57.19 | 2.31x | $75.15 | $292.2K | 6.9K | 1.8K |
| 2021 | $128.54 | $71.46 | 1.80x | $57.08 | $269.5K | 5.4K | 1.3K |
| 2022 | $128.57 | $70.49 | 1.82x | $58.08 | $198.0K | 4.1K | 757 |
| 2023 | $128.60 | $67.56 | 1.90x | $61.04 | $124.8K | 2.9K | 571 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99334 | Established patient assisted living visit, typically 15 minutes | 39.2K | $1.9M | $47.71 | 2.10x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 23.1K | $768.7K | $33.27 | 3.01x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 5.6K | $486.2K | $86.22 | 2.32x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 6.9K | $258.8K | $37.43 | 2.67x |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.9K | $177.1K | $60.73 | 1.65x |
| 90791 | Psychiatric diagnostic evaluation | 980 | $105.9K | $108.06 | 1.85x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $75.6K | $59.77 | 1.67x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 1.7K | $59.3K | $35.68 | 2.81x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 700 | $52.6K | $75.15 | 2.66x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 1.2K | $38.7K | $32.72 | 3.06x |
| M0064 | Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders | 768 | $30.3K | $39.48 | 3.16x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 34 | $2.1K | $61.54 | 3.25x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 16 | $1.4K | $84.59 | 2.36x |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic | 72 | $621.01 | $8.63 | 2.70x |
This provider submits charges 2.34 times higher than what Medicare actually pays.
A markup ratio of 2.34x means for every $100 Medicare pays, this provider initially charges $234. 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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