This provider's $3.8M 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 | $131.48 | $80.43 | 1.63x | $51.05 | $389.6K | 5.9K | 788 |
| 2015 | $105.50 | $68.54 | 1.54x | $36.96 | $446.1K | 8.4K | 1.5K |
| 2016 | $100.74 | $60.23 | 1.67x | $40.51 | $551.1K | 11.3K | 1.9K |
| 2017 | $119.40 | $61.59 | 1.94x | $57.81 | $396.2K | 8.3K | 1.5K |
| 2018 | $119.38 | $65.20 | 1.83x | $54.18 | $275.3K | 5.8K | 994 |
| 2019 | $108.33 | $60.87 | 1.78x | $47.46 | $296.6K | 6.0K | 938 |
| 2020 | $108.33 | $62.41 | 1.74x | $45.92 | $429.1K | 8.3K | 1.1K |
| 2021 | $109.00 | $64.45 | 1.69x | $44.55 | $342.5K | 6.8K | 968 |
| 2022 | $109.00 | $64.59 | 1.69x | $44.41 | $355.4K | 7.1K | 959 |
| 2023 | $109.00 | $66.70 | 1.63x | $42.30 | $295.7K | 5.6K | 772 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 90833 | Psychotherapy, 30 minutes with patient and/or family member | 34.2K | $1.6M | $47.58 | 1.47x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 23.3K | $1.2M | $53.00 | 1.43x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 5.2K | $391.8K | $75.06 | 1.59x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 7.1K | $204.3K | $28.77 | 1.65x |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.5K | $114.3K | $78.25 | 1.36x |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.0K | $109.5K | $107.00 | 2.34x |
| 99238 | Hospital discharge day management, 30 minutes or less | 742 | $38.6K | $52.03 | 2.02x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 381 | $34.7K | $91.14 | 2.19x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 146 | $21.3K | $145.80 | 1.55x |
This provider submits charges 1.51 times higher than what Medicare actually pays.
A markup ratio of 1.51x means for every $100 Medicare pays, this provider initially charges $151. 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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