92609

Therapy service for use of speech-generating device with programming

Medicare pricing data for 434 providers across 23 states

🤖AI Overview

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

Therapy service for use of speech-generating device with programming (HCPCS code 92609) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $104.34, but hospitals typically charge $155.22 — a 1.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$20.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $104.34, your out-of-pocket cost would be approximately $20.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$104.34
Average Hospital Charge
$155.22
Markup Ratio
1.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$155.22
Medicare Allowed$104.34
Medicare Payment$81.38

Hospitals charge 1.5x more than what Medicare allows for this procedure. Medicare actually pays $81.38 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$113$1965190+8.3%
California$111$19720216+6.4%
New York$110$148682,985+5.5%
New Jersey$108$18339776+3.8%
Maryland$105$14418450+0.6%
Colorado$105$129234,560+0.3%
Washington$104$2537219-0.3%
Texas$103$19013774-0.9%
Montana$103$19210240-1.1%
Pennsylvania$102$18828154-2.1%
Minnesota$102$17215238-2.3%
Florida$102$12512158-2.6%
Virginia$102$1879303-2.7%
Illinois$101$15713131-3.0%
Missouri$101$2644144-3.0%
Wisconsin$98$1325119-5.9%
North Carolina$98$1147177-6.2%
Ohio$97$19010136-7.1%
Idaho$96$11913190-8.1%
Nebraska$95$2018405-8.5%
Kansas$91$177396-13.2%
Kentucky$80$1199141-23.1%
Arizona$73$2121059-30.4%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber