Psychiatric services complicated by communication factor
Medicare pricing data for 6,219 providers across 51 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Psychiatric services complicated by communication factor (HCPCS code 90785) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.59, but hospitals typically charge $47.13 — a 3.7x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.59, your out-of-pocket cost would be approximately $2.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $9.76 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $18 | $61 | 16 | 81 | +43.3% |
| California | $15 | $56 | 581 | 71,989 | +17.6% |
| Puerto Rico | $15 | $18 | 5 | 19 | +17.3% |
| Connecticut | $14 | $61 | 45 | 1,440 | +12.9% |
| Maryland | $14 | $78 | 102 | 2,786 | +8.3% |
| New York | $14 | $66 | 364 | 19,967 | +7.3% |
| Oregon | $13 | $26 | 76 | 1,427 | +4.9% |
| Hawaii | $13 | $48 | 19 | 238 | +2.3% |
| Florida | $13 | $42 | 401 | 17,706 | +1.2% |
| Arizona | $13 | $40 | 109 | 3,153 | +1.2% |
| Nebraska | $13 | $35 | 37 | 341 | +0.4% |
| Vermont | $13 | $40 | 9 | 226 | -0.2% |
| Virginia | $12 | $32 | 100 | 3,977 | -0.9% |
| Massachusetts | $12 | $37 | 218 | 4,745 | -1.2% |
| New Jersey | $12 | $102 | 179 | 11,840 | -1.2% |
| West Virginia | $12 | $26 | 7 | 344 | -1.3% |
| Georgia | $12 | $68 | 121 | 5,788 | -1.4% |
| Washington | $12 | $29 | 133 | 2,095 | -1.7% |
| South Dakota | $12 | $28 | 14 | 128 | -2.2% |
| South Carolina | $12 | $29 | 76 | 3,301 | -2.6% |
| Louisiana | $12 | $38 | 72 | 1,748 | -2.7% |
| Pennsylvania | $12 | $67 | 177 | 6,998 | -2.7% |
| Alabama | $12 | $58 | 41 | 361 | -4.0% |
| Tennessee | $12 | $57 | 66 | 1,472 | -4.8% |
| Colorado | $12 | $44 | 124 | 2,762 | -4.9% |
| Minnesota | $12 | $39 | 534 | 7,907 | -5.0% |
| North Carolina | $12 | $34 | 174 | 3,199 | -5.3% |
| Kentucky | $12 | $27 | 80 | 4,470 | -5.6% |
| New Hampshire | $12 | $29 | 17 | 614 | -5.6% |
| Nevada | $12 | $31 | 41 | 5,914 | -6.0% |
| Indiana | $12 | $29 | 133 | 35,828 | -6.3% |
| Wisconsin | $12 | $69 | 108 | 1,077 | -6.6% |
| Delaware | $12 | $49 | 25 | 892 | -6.8% |
| Illinois | $12 | $34 | 276 | 18,127 | -7.4% |
| Texas | $12 | $66 | 298 | 37,994 | -7.5% |
| Ohio | $12 | $27 | 499 | 14,609 | -7.9% |
| Michigan | $12 | $30 | 293 | 20,725 | -8.0% |
| New Mexico | $12 | $23 | 68 | 1,893 | -8.0% |
| Missouri | $11 | $23 | 60 | 2,264 | -8.7% |
| Kansas | $11 | $27 | 46 | 467 | -8.9% |
| Idaho | $11 | $31 | 69 | 1,271 | -9.3% |
| Rhode Island | $11 | $126 | 52 | 693 | -9.5% |
| Montana | $11 | $21 | 15 | 288 | -11.4% |
| Utah | $11 | $24 | 40 | 691 | -12.2% |
| Mississippi | $11 | $30 | 21 | 120 | -12.7% |
| North Dakota | $11 | $28 | 28 | 496 | -12.8% |
| Arkansas | $11 | $32 | 39 | 915 | -13.1% |
| Wyoming | $11 | $24 | 16 | 287 | -13.2% |
| Iowa | $11 | $23 | 85 | 1,501 | -13.8% |
| Oklahoma | $11 | $17 | 59 | 13,337 | -14.2% |
| Maine | $11 | $32 | 26 | 2,006 | -15.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber