This provider's $3.3M in total Medicare payments ranks in the 99th percentile of Geriatric 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 | $140.00 | $88.81 | 1.58x | $51.19 | $432.7K | 4.9K | 1.8K |
| 2015 | $140.00 | $85.32 | 1.64x | $54.68 | $388.4K | 4.8K | 1.8K |
| 2016 | $170.13 | $96.37 | 1.77x | $73.76 | $553.5K | 6.7K | 2.1K |
| 2017 | $165.00 | $95.82 | 1.72x | $69.18 | $527.9K | 6.5K | 1.9K |
| 2018 | $156.25 | $92.22 | 1.69x | $64.03 | $374.3K | 4.7K | 1.6K |
| 2019 | $160.14 | $78.71 | 2.03x | $81.43 | $305.7K | 3.9K | 1.3K |
| 2020 | $169.96 | $77.89 | 2.18x | $92.07 | $209.0K | 2.7K | 1.0K |
| 2021 | $232.25 | $87.10 | 2.67x | $145.15 | $181.6K | 2.4K | 855 |
| 2022 | $200.00 | $74.08 | 2.70x | $125.92 | $144.2K | 2.1K | 605 |
| 2023 | $200.00 | $80.67 | 2.48x | $119.33 | $154.0K | 1.9K | 630 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 15.2K | $1.1M | $75.29 | 1.81x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 12.0K | $678.7K | $56.73 | 2.06x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 4.3K | $597.7K | $138.64 | 1.95x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 4.5K | $387.5K | $85.36 | 1.79x |
| 99310 | Subsequent nursing facility visit, typically 35 minutes per day | 2.4K | $265.3K | $110.94 | 1.42x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 343 | $57.0K | $166.24 | 1.64x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 507 | $54.7K | $107.84 | 1.85x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 527 | $31.2K | $59.20 | 2.09x |
| 99238 | Hospital discharge day management, 30 minutes or less | 422 | $25.0K | $59.30 | 1.69x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 130 | $14.7K | $113.20 | 2.21x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 188 | $6.8K | $35.92 | 2.36x |
| 99336 | Established patient assisted living visit, typically 40 minutes | 37 | $4.1K | $110.26 | 1.81x |
| 99239 | Hospital discharge day management, more than 30 minutes | 43 | $3.8K | $88.04 | 2.64x |
This provider submits charges 1.86 times higher than what Medicare actually pays.
A markup ratio of 1.86x means for every $100 Medicare pays, this provider initially charges $186. 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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