90833

Psychotherapy with evaluation and management visit, 30 minutes

Medicare pricing data for 20,103 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.4 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Psychotherapy with evaluation and management visit, 30 minutes (HCPCS code 90833) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $62.89, but hospitals typically charge $135.67 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.58

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $62.89, your out-of-pocket cost would be approximately $12.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$62.89
Average Hospital Charge
$135.67
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$135.67
Medicare Allowed$62.89
Medicare Payment$47.80

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $47.80 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$84$179581,715+33.7%
New York$70$1551,688153,810+12.0%
Puerto Rico$66$74551,585+5.2%
New Jersey$66$14270276,721+4.8%
California$66$1501,732220,137+4.2%
Connecticut$65$13427516,694+3.2%
New Hampshire$64$1251055,422+1.3%
Massachusetts$64$14496665,073+1.1%
Vermont$64$118482,300+1.1%
Pennsylvania$63$14057635,025+0.9%
District of Columbia$63$129863,334+0.8%
Rhode Island$63$1271867,819+0.3%
Florida$63$1311,280122,099+0.2%
West Virginia$63$111582,755-0.2%
Illinois$62$13178763,375-1.1%
Hawaii$62$120944,637-1.7%
Michigan$62$11649120,384-1.7%
Maryland$62$11076055,335-2.0%
Virginia$61$12057528,184-2.9%
South Dakota$61$113321,358-3.1%
Delaware$61$125837,235-3.4%
Wisconsin$61$17527214,393-3.8%
Texas$60$1271,23875,524-3.9%
Washington$60$13744817,034-4.3%
Missouri$60$12622917,319-4.3%
Montana$60$137863,592-4.5%
Kansas$60$1291063,553-4.5%
Colorado$60$13642415,716-4.5%
North Carolina$60$13266033,101-4.8%
Georgia$60$12855754,214-4.9%
Oklahoma$60$1101386,410-4.9%
Ohio$60$11492437,071-5.2%
South Carolina$59$11026021,211-5.4%
Indiana$59$1211625,136-5.5%
Utah$59$1382085,611-5.7%
Maine$59$141832,386-6.2%
Alabama$59$10527526,177-6.3%
Nevada$59$13325226,621-6.6%
Oregon$59$1592699,520-6.9%
Kentucky$58$12134414,776-7.0%
Arizona$58$13151633,566-7.3%
Iowa$58$1331664,734-7.8%
North Dakota$58$15627660-8.6%
Tennessee$57$11236720,145-8.9%
New Mexico$57$1011297,074-9.0%
Mississippi$57$1061255,222-9.1%
Louisiana$57$10324710,012-9.6%
Minnesota$56$16740619,485-10.7%
Nebraska$56$1621696,095-11.0%
Arkansas$56$1261998,315-11.1%
Idaho$55$1401406,267-13.1%
Wyoming$54$9821488-14.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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