This provider's $3.7M 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 | $166.67 | $80.85 | 2.06x | $85.82 | $375.2K | 5.6K | 1.1K |
| 2015 | $166.67 | $80.43 | 2.07x | $86.24 | $370.0K | 5.6K | 954 |
| 2016 | $166.67 | $81.26 | 2.05x | $85.41 | $351.6K | 5.5K | 1.0K |
| 2017 | $166.67 | $80.93 | 2.06x | $85.74 | $363.7K | 5.5K | 1.0K |
| 2018 | $132.04 | $58.88 | 2.24x | $73.16 | $328.1K | 5.2K | 885 |
| 2019 | $128.38 | $63.47 | 2.02x | $64.91 | $358.2K | 5.4K | 923 |
| 2020 | $127.50 | $62.60 | 2.04x | $64.90 | $367.0K | 5.2K | 755 |
| 2021 | $127.56 | $72.06 | 1.77x | $55.50 | $402.1K | 4.9K | 578 |
| 2022 | $146.35 | $84.49 | 1.73x | $61.86 | $401.7K | 4.8K | 537 |
| 2023 | $172.23 | $90.61 | 1.90x | $81.62 | $368.8K | 4.7K | 523 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.6K | $1.6M | $97.66 | 1.54x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 26.0K | $1.5M | $56.18 | 2.67x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.5K | $406.1K | $62.78 | 1.91x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.3K | $89.0K | $38.27 | 2.35x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 756 | $66.2K | $87.53 | 2.06x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 131 | $22.3K | $170.45 | 1.58x |
| 90791 | Psychiatric diagnostic evaluation | 92 | $10.0K | $108.52 | 2.49x |
| 99238 | Hospital discharge day management, 30 minutes or less | 150 | $9.2K | $61.55 | 1.95x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 44 | $5.7K | $130.05 | 1.68x |
This provider submits charges 2.06 times higher than what Medicare actually pays.
A markup ratio of 2.06x means for every $100 Medicare pays, this provider initially charges $206. 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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