This provider's $3.7M in total Medicare payments ranks in the 98th percentile of Physical Medicine and Rehabilitation providers nationally.
Medicare payments to this provider grew 492% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 163% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $129.94 | $71.20 | 1.82x | $58.74 | $125.9K | 2.2K | 1.1K |
| 2015 | $130.04 | $72.51 | 1.79x | $57.53 | $57.3K | 971 | 561 |
| 2016 | $129.90 | $72.44 | 1.79x | $57.46 | $68.4K | 1.2K | 681 |
| 2017 | $131.89 | $76.74 | 1.72x | $55.15 | $133.1K | 2.3K | 1.2K |
| 2018 | $119.38 | $67.44 | 1.77x | $51.94 | $350.7K | 8.7K | 5.5K |
| 2019 | $123.67 | $65.33 | 1.89x | $58.34 | $324.4K | 9.2K | 5.3K |
| 2020 | $142.25 | $70.22 | 2.03x | $72.03 | $503.5K | 10.8K | 5.6K |
| 2021 | $141.86 | $68.13 | 2.08x | $73.73 | $668.0K | 12.3K | 6.5K |
| 2022 | $135.05 | $62.54 | 2.16x | $72.51 | $696.1K | 12.9K | 6.5K |
| 2023 | $139.38 | $64.39 | 2.16x | $74.99 | $745.5K | 11.9K | 6.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 4.1K | $595.9K | $146.12 | 2.19x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 6.0K | $489.0K | $81.31 | 2.03x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 15.4K | $475.4K | $30.80 | 2.10x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 8.2K | $462.7K | $56.15 | 2.06x |
| G0180 | Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple | 12.2K | $460.9K | $37.79 | 1.86x |
| G0179 | Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp | 14.3K | $413.2K | $28.82 | 1.94x |
| 99239 | Hospital discharge day management, more than 30 minutes | 3.5K | $291.3K | $82.07 | 2.06x |
| 99497 | Advance care planning by the physician or other qualified health care professional, first 30 minutes | 2.8K | $165.5K | $58.12 | 2.25x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 1.0K | $125.2K | $124.37 | 1.70x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 2.9K | $94.8K | $33.03 | 2.06x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.3K | $64.5K | $51.03 | 1.97x |
| 99316 | Nursing facility discharge management, more than 30 minutes | 425 | $33.5K | $78.91 | 1.66x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 25 | $1.2K | $47.80 | 1.26x |
This provider submits charges 2.04 times higher than what Medicare actually pays.
A markup ratio of 2.04x means for every $100 Medicare pays, this provider initially charges $204. 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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