G0444

Annual depression screening, 5 to 15 minutes

Code G0444. Medicare covered 2,586,676 of these. Here is what providers billed and what Medicare allowed, state by state.

$40.85Billed, national avg
$17.76Medicare allowed
2.3xBilled vs allowed
8.8xHighest vs lowest state

Providers in Unknown billed the most for this, at $150.00. In Foreign Country the average was $17.14. 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
Unknown$150.00$18.378.2x137
Alaska$70.43$19.733.6x488
Massachusetts$58.76$18.753.1x90,931
District of Columbia$55.71$21.122.6x2,975
Virgin Islands$54.08$17.253.1x243
New York$51.00$20.202.5x119,009
Minnesota$48.78$17.372.8x3,115
Washington$46.92$17.252.7x21,664
Ohio$46.33$14.183.3x66,896
Tennessee$46.13$16.432.8x112,998
New Jersey$45.96$20.322.3x108,048
California$45.45$20.442.2x187,216
Nevada$44.66$18.012.5x23,135
Georgia$44.42$16.932.6x102,475
Connecticut$43.67$19.382.3x21,525
Texas$42.50$17.512.4x171,133
New Mexico$42.35$16.512.6x8,503
Illinois$41.59$18.522.2x53,153
North Dakota$41.59$13.743.0x1,065
Oregon$40.85$16.882.4x10,477
Rhode Island$40.51$18.712.2x6,737
Florida$40.19$17.832.3x432,758
Maine$39.94$17.932.2x1,190
Iowa$39.89$15.872.5x23,564
South Carolina$39.04$16.762.3x51,456
Wyoming$38.30$17.402.2x1,486
Colorado$38.27$18.442.1x24,444
Maryland$37.95$19.312.0x79,919
North Carolina$37.87$16.612.3x94,606
Kansas$37.52$16.502.3x33,126
Mississippi$37.08$14.772.5x46,081
West Virginia$37.07$14.762.5x6,763
Indiana$36.23$17.002.1x41,142
Missouri$35.91$16.792.1x23,416
Oklahoma$35.55$16.292.2x16,777
Virginia$35.45$18.391.9x75,504
Arizona$35.26$17.042.1x96,633
Utah$34.33$17.352.0x15,704
Wisconsin$33.63$17.032.0x5,142
Hawaii$33.57$19.301.7x4,562
Louisiana$33.47$16.372.0x19,212
Michigan$33.14$17.301.9x80,255
Pennsylvania$32.52$17.901.8x96,610
Idaho$32.12$16.112.0x8,107
Delaware$32.03$18.131.8x20,695
Kentucky$32.00$15.942.0x22,895
Alabama$31.99$16.102.0x63,293
Vermont$31.95$17.291.8x3,312
Nebraska$31.91$16.531.9x38,213
Arkansas$31.08$16.161.9x30,361
Montana$28.17$15.191.9x4,994
New Hampshire$27.00$11.842.3x8,967
Guam$26.86$19.391.4x684
Puerto Rico$26.84$17.431.5x186
South Dakota$24.40$15.961.5x2,622
Foreign Country$17.14$11.341.5x29

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

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