This provider's $6.3M 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.
Notable: Payments increased 131% in 2022
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 | $341.43 | $94.78 | 3.60x | $246.65 | $451.9K | 6.8K | 1.1K |
| 2015 | $434.01 | $98.39 | 4.41x | $335.62 | $517.3K | 7.1K | 1.8K |
| 2016 | $436.67 | $106.87 | 4.09x | $329.80 | $530.2K | 7.3K | 1.9K |
| 2017 | $405.00 | $93.63 | 4.33x | $311.37 | $558.0K | 7.4K | 2.0K |
| 2018 | $416.97 | $99.71 | 4.18x | $317.26 | $812.6K | 10.4K | 2.2K |
| 2019 | $404.00 | $98.51 | 4.10x | $305.49 | $1.0M | 13.2K | 2.4K |
| 2020 | $404.00 | $102.51 | 3.94x | $301.49 | $982.0K | 12.3K | 2.2K |
| 2021 | $404.00 | $99.13 | 4.08x | $304.87 | $289.6K | 3.6K | 1.0K |
| 2022 | $314.29 | $82.15 | 3.83x | $232.14 | $667.9K | 11.4K | 2.6K |
| 2023 | $260.00 | $69.38 | 3.75x | $190.62 | $462.2K | 8.1K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 47.1K | $2.7M | $57.89 | 4.49x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 16.5K | $1.4M | $83.22 | 4.45x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 6.7K | $1.1M | $159.84 | 4.00x |
| 99239 | Hospital discharge day management, more than 30 minutes | 5.6K | $476.3K | $85.81 | 4.32x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.2K | $232.4K | $103.99 | 3.95x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 6.5K | $222.1K | $34.43 | 2.34x |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.4K | $141.8K | $60.36 | 4.97x |
| 99221 | Initial hospital inpatient care per day, typically 30 minutes | 514 | $37.1K | $72.13 | 2.08x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 16 | $2.5K | $156.47 | 2.88x |
| 99328 | New patient assisted living visit, typically 75 minutes | 15 | $2.5K | $165.37 | 2.33x |
| 99335 | Established patient assisted living visit, typically 25 minutes | 27 | $2.1K | $76.35 | 2.55x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 21 | $1.7K | $83.21 | 3.12x |
This provider submits charges 4.28 times higher than what Medicare actually pays.
A markup ratio of 4.28x means for every $100 Medicare pays, this provider initially charges $428. 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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