This provider's $5.1M 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 | $121.88 | $74.28 | 1.64x | $47.60 | $524.9K | 9.5K | 2.7K |
| 2015 | $120.77 | $72.87 | 1.66x | $47.90 | $465.5K | 8.5K | 2.0K |
| 2016 | $114.00 | $70.33 | 1.62x | $43.67 | $388.2K | 6.5K | 2.1K |
| 2017 | $120.77 | $71.27 | 1.69x | $49.50 | $526.0K | 9.1K | 2.4K |
| 2018 | $137.14 | $76.53 | 1.79x | $60.61 | $449.9K | 8.3K | 1.8K |
| 2019 | $133.00 | $76.35 | 1.74x | $56.65 | $587.0K | 11.2K | 2.0K |
| 2020 | $107.27 | $62.81 | 1.71x | $44.46 | $469.5K | 9.1K | 1.9K |
| 2021 | $117.69 | $78.37 | 1.50x | $39.32 | $554.4K | 8.9K | 2.3K |
| 2022 | $136.57 | $86.52 | 1.58x | $50.05 | $544.0K | 8.8K | 2.1K |
| 2023 | $154.39 | $82.47 | 1.87x | $71.92 | $545.1K | 8.4K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 19.6K | $1.7M | $86.20 | 1.91x |
| 90836 | Psychotherapy, 45 minutes with patient and/or family member | 26.3K | $1.3M | $50.66 | 1.44x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 4.4K | $499.3K | $114.15 | 2.07x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 6.4K | $366.9K | $57.68 | 1.50x |
| 90838 | Psychotherapy, 60 minutes with patient and/or family member | 4.6K | $336.4K | $73.83 | 1.30x |
| 90785 | Interactive complexity | 16.9K | $189.9K | $11.23 | 3.12x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.9K | $161.0K | $55.96 | 1.81x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 839 | $127.4K | $151.86 | 1.76x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 756 | $115.5K | $152.80 | 1.34x |
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 3.3K | $110.2K | $33.61 | 1.36x |
| 99238 | Hospital discharge day management, 30 minutes or less | 609 | $35.5K | $58.31 | 2.06x |
| 96112 | Developmental test administration by qualified health care professional with interpretation and report, first 60 minutes | 997 | $28.3K | $28.36 | 1.35x |
| 99483 | Assessment of and care planning for patient with impaired thought processing, typically 60 minutes | 109 | $15.3K | $140.53 | 1.27x |
| 96136 | Psychological or neuropsychological test administration and scoring by qualified health care professional, first 30 minutes | 256 | $8.9K | $34.88 | 1.86x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 121 | $8.7K | $71.75 | 1.32x |
| 96101 | Psychological testing with interpretation and report by psychologist or physician per hour | 107 | $6.9K | $64.78 | 2.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 57 | $6.8K | $119.87 | 2.00x |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 70 | $6.7K | $95.68 | 2.61x |
| 99239 | Hospital discharge day management, more than 30 minutes | 51 | $4.7K | $91.92 | 2.72x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 13 | $2.3K | $174.13 | 1.49x |
This provider submits charges 1.74 times higher than what Medicare actually pays.
A markup ratio of 1.74x means for every $100 Medicare pays, this provider initially charges $174. 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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