90837

Psychotherapy, 1 hour

Medicare pricing data for 68,277 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 6.2 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, 1 hour (HCPCS code 90837) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $121.38, but hospitals typically charge $201.70 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $121.38, your out-of-pocket cost would be approximately $24.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$121.38
Average Hospital Charge
$201.70
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$201.70
Medicare Allowed$121.38
Medicare Payment$93.58

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $93.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$167$29413112,645+37.3%
California$138$2155,387728,104+13.6%
Puerto Rico$131$1481512,302+8.0%
District of Columbia$131$20420518,784+8.0%
Hawaii$127$22633020,643+4.4%
New York$126$2034,747496,607+3.6%
Pennsylvania$125$1913,236331,927+3.4%
New Jersey$124$2122,343264,617+2.1%
Washington$123$2021,329110,793+1.5%
Florida$123$2033,581501,562+1.5%
New Hampshire$122$18154355,384+0.6%
Arizona$122$20777187,998+0.3%
Maryland$122$1831,926199,987+0.2%
Colorado$121$2111,584111,649-0.5%
Illinois$121$2093,575350,273-0.5%
Massachusetts$119$1973,289314,206-1.6%
Texas$119$2062,561241,620-1.8%
Connecticut$119$1861,497104,379-2.0%
Nevada$119$20747044,656-2.3%
Rhode Island$118$18537222,722-3.2%
North Dakota$117$27426612,525-3.5%
West Virginia$117$20932518,809-3.6%
Oregon$117$2211,08572,918-4.0%
Ohio$116$1922,632165,944-4.0%
Minnesota$116$2472,185131,516-4.3%
Mississippi$116$20323430,570-4.4%
Delaware$116$18733535,168-4.4%
Georgia$116$1891,092112,678-4.7%
Virginia$115$1801,642131,955-5.1%
South Carolina$115$18865661,986-5.2%
Missouri$115$17090280,168-5.2%
Vermont$115$15750257,031-5.3%
Wisconsin$115$2571,25178,073-5.3%
Tennessee$115$18271353,381-5.3%
South Dakota$115$20025419,818-5.6%
Michigan$114$2014,439271,693-5.8%
New Mexico$114$18160045,630-6.3%
Alabama$113$19640724,331-6.7%
Wyoming$113$18718020,765-6.8%
Oklahoma$113$17556451,852-6.9%
North Carolina$112$2142,237183,462-7.4%
Utah$112$19674737,930-7.4%
Montana$112$17550848,778-7.6%
Nebraska$112$22639729,082-8.0%
Kansas$111$18176962,479-8.7%
Indiana$111$1931,20161,456-8.7%
Idaho$110$18134921,028-9.1%
Louisiana$110$16753938,118-9.8%
Kentucky$109$19290949,079-10.3%
Iowa$109$19867939,229-10.4%
Arkansas$108$21364452,053-10.8%
Maine$108$17296268,300-11.1%

⚠️ 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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