This provider's $3.6M in total Medicare payments ranks in the 99th percentile of Psychiatry providers nationally.
Medicare payments to this provider grew 167% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 60% in 2020
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $1.1K | $207.46 | 5.12x | $853.87 | $221.8K | 1.4K | 904 |
| 2015 | $1.1K | $210.75 | 5.30x | $906.06 | $237.8K | 1.4K | 962 |
| 2016 | $1.0K | $198.86 | 5.27x | $850.09 | $267.9K | 1.7K | 1.2K |
| 2017 | $1.1K | $197.71 | 5.69x | $927.75 | $263.6K | 1.7K | 1.2K |
| 2018 | $1.2K | $207.37 | 5.63x | $960.76 | $225.6K | 1.4K | 1.0K |
| 2019 | $998.14 | $175.27 | 5.69x | $822.87 | $269.9K | 1.7K | 1.3K |
| 2020 | $907.64 | $168.56 | 5.38x | $739.08 | $431.4K | 4.1K | 2.1K |
| 2021 | $1.0K | $181.08 | 5.73x | $855.89 | $557.4K | 5.5K | 2.9K |
| 2022 | $758.00 | $162.97 | 4.65x | $595.03 | $523.2K | 3.7K | 2.8K |
| 2023 | $877.38 | $193.57 | 4.53x | $683.81 | $592.2K | 4.8K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 1.8K | $794.3K | $448.52 | 6.81x |
| 95800 | Study of sleep patterns | 4.5K | $703.2K | $157.56 | 4.69x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 1.3K | $502.4K | $397.50 | 6.60x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.2K | $378.2K | $89.74 | 2.39x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.5K | $272.7K | $60.68 | 2.92x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.1K | $237.6K | $114.63 | 3.28x |
| 99091 | Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days | 2.5K | $120.3K | $47.53 | 5.23x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1.7K | $111.3K | $65.38 | 3.82x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 1.0K | $104.5K | $102.42 | 7.40x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 610 | $104.0K | $170.46 | 2.65x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $83.8K | $66.54 | 4.52x |
| 94660 | Initiation and management of continued pressured respiratory assistance by mask or breathing tube | 1.5K | $78.6K | $52.80 | 2.84x |
| G0398 | Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation | 274 | $78.1K | $284.86 | 2.57x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 57 | $9.9K | $172.99 | 2.60x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 30 | $4.2K | $138.70 | 2.36x |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | 44 | $4.1K | $93.20 | 5.89x |
| 99457 | Remote monitoring of physiologic parameters management services, 20 minutes or more of qualified health care professional time per calendar month | 55 | $2.7K | $48.26 | 4.12x |
| 95004 | Injection of allergenic extracts into skin, accessed through the skin | 209 | $1.2K | $5.54 | 2.53x |
This provider submits charges 4.87 times higher than what Medicare actually pays.
A markup ratio of 4.87x means for every $100 Medicare pays, this provider initially charges $487. 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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