Psychotherapy with evaluation and management visit, 1 hour
Medicare pricing data for 3,438 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
Psychotherapy with evaluation and management visit, 1 hour (HCPCS code 90838) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $109.85, but hospitals typically charge $213.70 — a 1.9x 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 $109.85, your out-of-pocket cost would be approximately $21.97. 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 1.9x more than what Medicare allows for this procedure. Medicare actually pays $85.39 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $146 | $442 | 20 | 424 | +32.5% |
| District of Columbia | $123 | $200 | 19 | 674 | +11.6% |
| New York | $118 | $203 | 262 | 10,590 | +7.6% |
| California | $117 | $240 | 343 | 14,614 | +6.7% |
| New Jersey | $116 | $244 | 101 | 7,530 | +5.2% |
| Maryland | $115 | $170 | 100 | 3,624 | +4.4% |
| Illinois | $113 | $202 | 96 | 1,539 | +2.8% |
| Pennsylvania | $112 | $206 | 110 | 2,599 | +1.5% |
| Hawaii | $111 | $214 | 37 | 1,318 | +1.1% |
| Maine | $110 | $219 | 16 | 208 | +0.0% |
| Michigan | $110 | $247 | 108 | 2,602 | -0.3% |
| Georgia | $109 | $201 | 57 | 1,658 | -0.5% |
| Connecticut | $109 | $168 | 58 | 2,390 | -0.9% |
| Virginia | $108 | $195 | 78 | 1,349 | -1.3% |
| New Hampshire | $108 | $174 | 31 | 868 | -1.4% |
| Wisconsin | $107 | $275 | 33 | 314 | -2.9% |
| Rhode Island | $106 | $199 | 25 | 324 | -3.1% |
| Minnesota | $106 | $240 | 57 | 492 | -3.2% |
| Massachusetts | $106 | $223 | 148 | 3,164 | -3.3% |
| Colorado | $106 | $167 | 73 | 1,469 | -3.6% |
| New Mexico | $106 | $221 | 27 | 1,305 | -3.9% |
| North Carolina | $105 | $237 | 103 | 1,370 | -4.1% |
| Florida | $105 | $214 | 252 | 5,348 | -4.2% |
| Missouri | $105 | $156 | 20 | 511 | -4.6% |
| North Dakota | $104 | $259 | 6 | 103 | -5.2% |
| Texas | $104 | $215 | 172 | 3,571 | -5.4% |
| Arkansas | $103 | $212 | 29 | 691 | -5.9% |
| Ohio | $103 | $183 | 155 | 1,858 | -6.1% |
| Washington | $102 | $212 | 116 | 2,421 | -7.1% |
| Wyoming | $102 | $228 | 7 | 38 | -7.1% |
| Alabama | $102 | $210 | 28 | 196 | -7.1% |
| Nevada | $102 | $205 | 40 | 886 | -7.5% |
| Vermont | $101 | $178 | 19 | 618 | -7.8% |
| Utah | $101 | $286 | 36 | 251 | -8.1% |
| West Virginia | $101 | $257 | 7 | 65 | -8.3% |
| Delaware | $100 | $214 | 24 | 531 | -8.6% |
| Arizona | $100 | $215 | 97 | 3,633 | -8.9% |
| Oklahoma | $99 | $212 | 36 | 787 | -9.5% |
| Tennessee | $99 | $168 | 68 | 1,053 | -9.5% |
| Oregon | $99 | $261 | 67 | 1,451 | -9.6% |
| Iowa | $98 | $246 | 31 | 313 | -10.4% |
| Louisiana | $98 | $195 | 30 | 507 | -10.5% |
| South Carolina | $98 | $133 | 48 | 2,585 | -10.5% |
| Indiana | $98 | $191 | 26 | 214 | -11.2% |
| Kansas | $96 | $168 | 24 | 655 | -13.0% |
| Kentucky | $95 | $172 | 47 | 588 | -13.2% |
| Nebraska | $93 | $240 | 22 | 183 | -15.1% |
| South Dakota | $93 | $272 | 7 | 155 | -15.5% |
| Idaho | $92 | $151 | 14 | 139 | -16.0% |
| Montana | $92 | $211 | 12 | 41 | -16.2% |
| Mississippi | $88 | $186 | 19 | 95 | -19.8% |
⚠️ 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