This provider's $5.4M 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 | $203.85 | $92.07 | 2.21x | $111.78 | $559.9K | 7.3K | 2.6K |
| 2015 | $197.44 | $90.12 | 2.19x | $107.32 | $566.2K | 7.6K | 2.5K |
| 2016 | $210.00 | $91.96 | 2.28x | $118.04 | $431.8K | 5.9K | 2.3K |
| 2017 | $197.59 | $72.71 | 2.72x | $124.88 | $468.2K | 6.4K | 2.2K |
| 2018 | $199.08 | $80.80 | 2.46x | $118.28 | $528.0K | 6.9K | 2.4K |
| 2019 | $184.86 | $93.68 | 1.97x | $91.18 | $556.0K | 6.9K | 2.4K |
| 2020 | $190.10 | $98.05 | 1.94x | $92.05 | $484.2K | 5.6K | 1.9K |
| 2021 | $188.64 | $116.31 | 1.62x | $72.33 | $554.4K | 5.9K | 2.1K |
| 2022 | $185.00 | $108.23 | 1.71x | $76.77 | $564.8K | 6.0K | 2.3K |
| 2023 | $190.91 | $109.68 | 1.74x | $81.23 | $703.3K | 7.0K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 33.2K | $2.1M | $64.75 | 3.15x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 18.2K | $1.7M | $96.03 | 1.94x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 5.5K | $734.7K | $134.14 | 2.24x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.2K | $267.4K | $124.13 | 1.81x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 1.2K | $103.6K | $83.47 | 2.05x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 375 | $67.5K | $179.93 | 1.78x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 1.2K | $62.8K | $52.68 | 2.37x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 758 | $45.4K | $59.91 | 1.67x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 407 | $37.6K | $92.44 | 1.90x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 507 | $29.7K | $58.58 | 2.13x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 142 | $28.7K | $202.11 | 1.57x |
| 99215 | Established patient outpatient visit, total time 40-54 minutes | 169 | $28.3K | $167.31 | 1.34x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 237 | $27.5K | $116.08 | 1.53x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 188 | $22.0K | $116.99 | 1.71x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 171 | $13.5K | $78.75 | 1.90x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 355 | $12.4K | $35.01 | 4.36x |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 146 | $9.5K | $65.02 | 1.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 146 | $9.2K | $63.02 | 2.38x |
| 90836 | Psychotherapy, 45 minutes with patient and/or family member | 122 | $8.5K | $69.43 | 2.02x |
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | 158 | $6.0K | $38.15 | 2.62x |
This provider submits charges 2.46 times higher than what Medicare actually pays.
A markup ratio of 2.46x means for every $100 Medicare pays, this provider initially charges $246. 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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