This provider's $3.9M 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 | $108.36 | $74.35 | 1.46x | $34.01 | $319.8K | 4.8K | 2.7K |
| 2015 | $110.00 | $74.87 | 1.47x | $35.13 | $355.2K | 5.1K | 3.2K |
| 2016 | $110.00 | $74.58 | 1.47x | $35.42 | $381.3K | 5.6K | 3.4K |
| 2017 | $110.00 | $74.92 | 1.47x | $35.08 | $367.1K | 5.3K | 3.4K |
| 2018 | $110.00 | $77.51 | 1.42x | $32.49 | $361.5K | 5.0K | 3.2K |
| 2019 | $110.13 | $77.28 | 1.43x | $32.85 | $369.5K | 5.1K | 3.3K |
| 2020 | $110.00 | $78.61 | 1.40x | $31.39 | $345.3K | 4.6K | 3.2K |
| 2021 | $150.86 | $90.24 | 1.67x | $60.62 | $417.1K | 4.7K | 3.2K |
| 2022 | $170.00 | $91.97 | 1.85x | $78.03 | $483.3K | 5.3K | 3.5K |
| 2023 | $170.00 | $93.38 | 1.82x | $76.62 | $450.4K | 5.0K | 3.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | 12.8K | $1.8M | $143.05 | 1.41x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 22.9K | $1.4M | $61.14 | 1.60x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 13.8K | $523.3K | $37.94 | 1.86x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 1.3K | $104.3K | $82.13 | 1.61x |
This provider submits charges 1.54 times higher than what Medicare actually pays.
A markup ratio of 1.54x means for every $100 Medicare pays, this provider initially charges $154. 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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