This provider's $4.5M in total Medicare payments ranks in the 99th percentile of Geriatric Psychiatry providers nationally.
68% of their billing comes from a single procedure code (99336 — Established patient assisted living visit, typically 40 minutes).
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 | $155.06 | $79.83 | 1.94x | $75.23 | $670.9K | 7.3K | 2.0K |
| 2015 | $155.09 | $75.29 | 2.06x | $79.80 | $701.1K | 7.6K | 2.1K |
| 2016 | $169.58 | $74.54 | 2.28x | $95.04 | $569.3K | 6.3K | 1.9K |
| 2017 | $182.28 | $83.94 | 2.17x | $98.34 | $506.4K | 5.2K | 1.6K |
| 2018 | $165.77 | $79.45 | 2.09x | $86.32 | $410.6K | 4.1K | 1.3K |
| 2019 | $171.50 | $86.75 | 1.98x | $84.75 | $463.1K | 4.4K | 1.3K |
| 2020 | $180.00 | $101.04 | 1.78x | $78.96 | $401.9K | 3.2K | 855 |
| 2021 | $180.00 | $90.31 | 1.99x | $89.69 | $336.6K | 3.0K | 809 |
| 2022 | $180.00 | $85.91 | 2.10x | $94.09 | $295.5K | 2.8K | 715 |
| 2023 | $202.48 | $84.28 | 2.40x | $118.20 | $177.6K | 1.8K | 479 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99336 | Established patient assisted living visit, typically 40 minutes | 27.3K | $3.1M | $112.98 | 1.55x |
| 99327 | New patient assisted living visit, typically 60 minutes | 1.9K | $293.3K | $155.44 | 2.25x |
| 90834 | Psychotherapy, 45 minutes with patient and/or family member | 3.7K | $249.3K | $67.59 | 1.78x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 2.3K | $194.7K | $82.99 | 1.51x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 2.3K | $186.3K | $79.43 | 2.08x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 1.4K | $144.5K | $104.64 | 2.39x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 1.9K | $105.3K | $55.19 | 1.64x |
| 90832 | Psychotherapy, 30 minutes with patient and/or family member | 2.1K | $102.6K | $49.77 | 1.81x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 1.7K | $72.6K | $43.44 | 4.03x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 336 | $36.7K | $109.09 | 1.83x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 233 | $26.7K | $114.76 | 3.05x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 198 | $12.1K | $60.98 | 2.87x |
| 99345 | Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes | 70 | $11.5K | $163.77 | 2.44x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im | 203 | $6.7K | $33.09 | 3.78x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 36 | $2.7K | $73.75 | 2.24x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 11 | $859.65 | $78.15 | 1.60x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 15 | $753.30 | $50.22 | 1.99x |
This provider submits charges 1.72 times higher than what Medicare actually pays.
A markup ratio of 1.72x means for every $100 Medicare pays, this provider initially charges $172. This is lower 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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