90834

Psychotherapy, 45 minutes

Code 90834. Medicare covered 3,373,356 of these. Here is what providers billed and what Medicare allowed, state by state.

$177.45Billed, national avg
$87.06Medicare allowed
2.0xBilled vs allowed
2.4xHighest vs lowest state

Providers in Alaska billed the most for this, at $248.45. In Puerto Rico the average was $101.44. 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$248.45$109.202.3x4,384
Wisconsin$243.29$79.043.1x54,814
Minnesota$232.26$83.332.8x73,363
Oregon$225.40$85.762.6x23,459
Foreign Country$222.92$83.572.7x60
Washington$207.00$89.872.3x27,787
Ohio$206.54$82.752.5x59,703
Virgin Islands$204.66$99.752.1x64
California$203.85$97.832.1x239,714
North Dakota$203.80$82.322.5x10,873
Connecticut$192.83$84.512.3x62,239
Colorado$191.70$85.782.2x35,333
West Virginia$190.47$80.422.4x5,907
Hawaii$190.15$96.522.0x2,697
New Jersey$186.20$90.582.1x218,139
Wyoming$185.63$80.042.3x5,810
North Carolina$182.04$80.452.3x44,796
Utah$181.17$81.832.2x11,069
New York$180.23$92.062.0x726,768
Nevada$179.13$82.912.2x6,914
District of Columbia$179.13$94.011.9x9,368
Georgia$178.78$82.062.2x33,213
Arizona$177.01$89.772.0x20,449
Nebraska$176.57$77.512.3x19,461
Massachusetts$175.42$84.432.1x333,696
Mississippi$171.18$79.312.2x3,073
Florida$170.70$87.372.0x119,727
Iowa$170.39$76.212.2x36,338
Alabama$168.83$75.472.2x5,063
Illinois$168.59$89.231.9x166,577
Montana$167.07$80.502.1x4,779
New Hampshire$166.21$83.252.0x39,824
Vermont$165.44$80.722.0x18,321
South Dakota$165.09$79.022.1x4,957
Louisiana$163.68$77.722.1x12,323
Rhode Island$162.33$83.142.0x16,616
Kentucky$161.93$76.502.1x13,182
Texas$160.47$84.651.9x175,692
Michigan$159.31$82.681.9x98,468
South Carolina$158.73$80.552.0x13,654
Maryland$158.66$83.571.9x156,311
Pennsylvania$157.49$88.171.8x127,322
Virginia$157.45$82.601.9x68,093
Tennessee$155.02$83.011.9x30,830
Arkansas$153.05$75.052.0x10,057
Idaho$152.81$75.402.0x19,518
New Mexico$152.75$83.481.8x13,476
Missouri$152.26$80.991.9x47,705
Kansas$152.05$81.681.9x22,777
Indiana$151.34$78.821.9x50,384
Delaware$151.26$84.381.8x15,019
Maine$142.73$76.111.9x14,020
Oklahoma$132.78$75.361.8x37,358
Puerto Rico$101.44$91.981.1x1,742

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

← All procedures