97129

Therapy procedure for a range of mental processes, initial 15 minutes

Medicare pricing data for 3,066 providers across 50 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 procedure for a range of mental processes, initial 15 minutes (HCPCS code 97129) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $22.62, but hospitals typically charge $48.79 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $22.62, your out-of-pocket cost would be approximately $4.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$22.62
Average Hospital Charge
$48.79
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$48.79
Medicare Allowed$22.62
Medicare Payment$17.81

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $17.81 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$25$448233+10.9%
New York$24$5922124,294+8.2%
District of Columbia$24$45897+7.2%
New Jersey$24$5421525,739+4.8%
New Hampshire$23$61131,373+3.0%
Maryland$23$42746,756+2.4%
Rhode Island$23$458752+2.1%
Connecticut$23$52141,050+1.9%
Minnesota$23$45471,251+1.6%
Delaware$23$45152,681+1.5%
California$23$5028120,147+1.4%
Massachusetts$23$49322,568+0.9%
Washington$23$41642,989+0.8%
Pennsylvania$23$4312919,861+0.7%
Hawaii$23$4681,299-0.1%
Virginia$23$47876,381-0.2%
Illinois$22$4312510,289-0.9%
Florida$22$5222019,685-0.9%
Nevada$22$58361,802-1.1%
Michigan$22$63632,519-1.6%
North Dakota$22$5625559-1.7%
Texas$22$5216412,425-1.8%
Oregon$22$3538641-1.8%
Georgia$22$45826,912-1.9%
Montana$22$5516437-2.1%
Colorado$22$421083,987-2.2%
Wyoming$22$4816778-2.8%
Maine$22$42251,132-3.0%
Nebraska$22$4620500-3.1%
Wisconsin$22$48544,438-3.1%
Ohio$22$465810,828-3.2%
Louisiana$22$53291,894-3.4%
New Mexico$22$3416459-3.4%
South Dakota$22$4612629-3.5%
South Carolina$22$446710,995-3.8%
Kentucky$22$47392,821-3.9%
Oklahoma$22$48253,656-4.0%
West Virginia$22$31201,252-4.0%
Kansas$22$43413,801-4.2%
Indiana$22$46616,755-4.2%
North Carolina$22$52872,792-4.2%
Tennessee$22$42814,448-4.5%
Iowa$22$42382,803-4.5%
Utah$22$4136913-4.6%
Missouri$22$51666,916-4.6%
Alabama$21$41231,218-5.1%
Arizona$21$45663,936-5.2%
Mississippi$21$43333,789-5.3%
Idaho$21$2614764-7.0%
Arkansas$21$7720489-7.5%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber