This provider's $3.5M 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 | $127.53 | $85.39 | 1.49x | $42.14 | $386.8K | 5.2K | 2.0K |
| 2015 | $125.27 | $82.79 | 1.51x | $42.48 | $392.7K | 5.5K | 2.3K |
| 2016 | $145.96 | $93.66 | 1.56x | $52.30 | $342.0K | 4.9K | 1.9K |
| 2017 | $138.47 | $86.01 | 1.61x | $52.46 | $332.8K | 5.0K | 2.2K |
| 2018 | $132.06 | $84.82 | 1.56x | $47.24 | $368.2K | 6.0K | 2.5K |
| 2019 | $134.80 | $91.32 | 1.48x | $43.48 | $350.0K | 5.4K | 1.5K |
| 2020 | $124.01 | $81.82 | 1.52x | $42.19 | $395.0K | 6.4K | 1.4K |
| 2021 | $146.25 | $96.18 | 1.52x | $50.07 | $318.7K | 5.2K | 1.1K |
| 2022 | $143.42 | $94.15 | 1.52x | $49.27 | $275.2K | 4.4K | 937 |
| 2023 | $146.81 | $93.21 | 1.58x | $53.60 | $339.2K | 5.3K | 1.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 22.2K | $1.2M | $53.11 | 1.60x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.0K | $524.1K | $86.86 | 1.44x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.9K | $482.2K | $61.01 | 1.64x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 1.8K | $299.4K | $166.17 | 1.50x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 6.0K | $200.7K | $33.41 | 1.95x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 827 | $112.2K | $135.65 | 1.48x |
| 90836 | Psychotherapy, 45 minutes with patient and/or family member | 1.6K | $112.1K | $68.53 | 1.60x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 930 | $110.7K | $119.04 | 1.68x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.1K | $100.0K | $88.95 | 1.46x |
| 99239 | Hospital discharge day management, more than 30 minutes | 752 | $67.8K | $90.17 | 1.33x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 789 | $55.8K | $70.71 | 1.58x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 389 | $44.0K | $113.00 | 1.73x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 530 | $39.7K | $74.98 | 1.36x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 557 | $31.5K | $56.57 | 1.34x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 267 | $28.4K | $106.54 | 1.88x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 167 | $28.4K | $170.26 | 1.47x |
| 99238 | Hospital discharge day management, 30 minutes or less | 449 | $27.5K | $61.33 | 1.63x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 257 | $19.5K | $76.00 | 1.57x |
| 99334 | Established patient assisted living visit, typically 15 minutes | 244 | $12.1K | $49.68 | 1.51x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 73 | $7.9K | $108.48 | 1.62x |
This provider submits charges 1.58 times higher than what Medicare actually pays.
A markup ratio of 1.58x means for every $100 Medicare pays, this provider initially charges $158. 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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