90833

Psychotherapy with evaluation and management visit, 30 minutes

Code 90833. Medicare covered 1,539,816 of these. Here is what providers billed and what Medicare allowed, state by state.

$142.11Billed, national avg
$64.70Medicare allowed
2.2xBilled vs allowed
2.5xHighest vs lowest state

Providers in Alaska billed the most for this, at $184.38. In Puerto Rico the average was $74.96. Same procedure code, same programme.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

By state

StateBilledMedicare allowedGapServices
Alaska$184.38$79.472.3x3,680
North Dakota$178.96$60.393.0x723
Wisconsin$175.19$62.552.8x13,527
Oregon$171.78$62.232.8x10,126
New York$171.16$72.132.4x165,276
Minnesota$170.20$61.162.8x20,762
Guam$169.16$65.482.6x105
Nebraska$161.84$57.692.8x6,041
Utah$158.21$61.342.6x7,563
California$154.11$66.652.3x250,008
Massachusetts$152.40$65.562.3x70,168
Washington$151.55$61.902.4x18,377
Maine$148.21$60.922.4x2,299
New Jersey$145.43$67.662.1x85,454
Montana$141.93$62.492.3x4,766
Illinois$140.63$64.112.2x66,254
North Carolina$139.73$61.432.3x32,129
Connecticut$139.21$67.752.1x15,717
Indiana$138.27$60.472.3x5,673
Idaho$138.20$57.312.4x9,135
Florida$137.30$64.602.1x140,271
Pennsylvania$137.02$65.842.1x31,934
Rhode Island$136.85$65.762.1x7,637
Georgia$136.37$62.322.2x51,890
Nevada$136.32$59.742.3x30,807
Kansas$136.20$60.232.3x4,401
New Hampshire$135.59$64.952.1x5,720
Iowa$134.59$60.222.2x5,108
Texas$134.44$62.922.1x94,331
Kentucky$133.23$60.502.2x14,385
Colorado$129.75$61.002.1x23,553
Virginia$129.51$63.002.1x33,693
District of Columbia$127.96$65.552.0x4,786
Missouri$127.95$62.402.1x14,290
Arkansas$126.59$57.362.2x9,581
Mississippi$124.99$59.032.1x5,693
Arizona$124.42$59.642.1x39,228
Ohio$124.13$61.612.0x38,822
Wyoming$123.97$57.602.2x707
Hawaii$123.04$64.901.9x5,011
Delaware$122.76$62.012.0x7,930
Vermont$122.53$65.961.9x2,523
Michigan$122.36$64.701.9x19,250
West Virginia$122.28$61.562.0x3,182
Oklahoma$120.35$61.362.0x6,523
South Dakota$117.19$63.231.9x1,171
Maryland$115.36$63.581.8x65,965
Tennessee$114.47$59.181.9x20,735
South Carolina$110.85$61.541.8x19,969
Louisiana$108.87$58.781.9x8,942
New Mexico$107.18$59.831.8x7,638
Alabama$102.59$59.961.7x24,541
Virgin Islands$96.50$61.821.6x94
$96.03$64.391.5x70
Puerto Rico$74.96$66.851.1x1,586

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

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