This provider's $3.8M 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 | $138.53 | $87.83 | 1.58x | $50.70 | $585.1K | 8.1K | 3.5K |
| 2015 | $156.68 | $92.79 | 1.69x | $63.89 | $358.2K | 5.1K | 1.8K |
| 2016 | $148.15 | $91.92 | 1.61x | $56.23 | $447.9K | 6.6K | 2.8K |
| 2017 | $130.98 | $80.11 | 1.64x | $50.87 | $389.5K | 6.0K | 2.3K |
| 2018 | $136.87 | $79.39 | 1.72x | $57.48 | $342.8K | 6.0K | 2.2K |
| 2019 | $136.60 | $87.57 | 1.56x | $49.03 | $273.8K | 4.5K | 1.6K |
| 2020 | $138.73 | $83.70 | 1.66x | $55.03 | $307.0K | 5.0K | 1.2K |
| 2021 | $143.72 | $92.17 | 1.56x | $51.55 | $344.7K | 4.9K | 1.3K |
| 2022 | $152.81 | $89.90 | 1.70x | $62.91 | $417.4K | 6.3K | 1.4K |
| 2023 | $153.45 | $91.43 | 1.68x | $62.02 | $350.1K | 5.1K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 19.5K | $1.1M | $54.18 | 1.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.0K | $693.7K | $62.87 | 1.74x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.4K | $446.0K | $60.62 | 1.41x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.0K | $437.0K | $87.51 | 1.44x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 2.1K | $346.2K | $162.70 | 1.54x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 2.3K | $264.8K | $113.30 | 1.81x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 4.2K | $140.2K | $33.01 | 1.81x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.4K | $83.1K | $61.26 | 1.64x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 603 | $67.4K | $111.70 | 1.58x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $38.5K | $34.24 | 2.19x |
| 99239 | Hospital discharge day management, more than 30 minutes | 391 | $35.9K | $91.73 | 1.90x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 277 | $31.3K | $112.87 | 1.34x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 407 | $31.1K | $76.39 | 1.64x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 181 | $24.4K | $134.86 | 1.32x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 332 | $19.3K | $58.14 | 1.71x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 108 | $16.9K | $156.23 | 1.44x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 148 | $14.9K | $100.57 | 1.74x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 210 | $14.4K | $68.46 | 1.46x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 343 | $12.9K | $37.59 | 1.99x |
| 99328 | New patient assisted living visit, typically 75 minutes | 62 | $10.4K | $166.95 | 1.39x |
This provider submits charges 1.61 times higher than what Medicare actually pays.
A markup ratio of 1.61x means for every $100 Medicare pays, this provider initially charges $161. 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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