Therapy procedure for a range of mental processes, each additional 15 minutes
Medicare pricing data for 2,380 providers across 50 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
Therapy procedure for a range of mental processes, each additional 15 minutes (HCPCS code 97130) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $21.69, but hospitals typically charge $47.24 — a 2.2x 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 $21.69, your out-of-pocket cost would be approximately $4.34. 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 2.2x more than what Medicare allows for this procedure. Medicare actually pays $17.15 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $27 | $62 | 7 | 261 | +24.0% |
| New York | $24 | $56 | 156 | 50,552 | +8.5% |
| District of Columbia | $23 | $43 | 4 | 106 | +5.8% |
| New Jersey | $23 | $48 | 167 | 53,707 | +4.5% |
| California | $23 | $65 | 189 | 18,373 | +4.1% |
| New Hampshire | $22 | $59 | 9 | 3,640 | +2.6% |
| Minnesota | $22 | $45 | 37 | 2,689 | +2.1% |
| Maryland | $22 | $41 | 66 | 14,432 | +1.9% |
| Rhode Island | $22 | $43 | 6 | 2,133 | +1.7% |
| Connecticut | $22 | $45 | 10 | 2,484 | +1.2% |
| Delaware | $22 | $42 | 13 | 5,634 | +1.2% |
| Massachusetts | $22 | $48 | 23 | 5,259 | +0.6% |
| Washington | $22 | $41 | 49 | 5,513 | +0.4% |
| Pennsylvania | $22 | $41 | 113 | 46,622 | +0.2% |
| Florida | $22 | $52 | 154 | 44,390 | 0.0% |
| Virginia | $22 | $42 | 54 | 14,443 | -0.4% |
| Hawaii | $22 | $45 | 8 | 3,485 | -0.6% |
| Illinois | $21 | $43 | 108 | 21,306 | -1.1% |
| Texas | $21 | $51 | 117 | 26,585 | -1.7% |
| Michigan | $21 | $66 | 46 | 5,294 | -1.8% |
| Georgia | $21 | $45 | 71 | 15,120 | -1.9% |
| Colorado | $21 | $43 | 86 | 5,840 | -1.9% |
| Nevada | $21 | $52 | 28 | 1,177 | -2.1% |
| North Dakota | $21 | $54 | 23 | 1,229 | -2.2% |
| Wyoming | $21 | $46 | 13 | 1,481 | -2.2% |
| Montana | $21 | $52 | 15 | 925 | -2.4% |
| Nebraska | $21 | $41 | 16 | 711 | -2.4% |
| Oregon | $21 | $34 | 30 | 1,086 | -2.9% |
| Missouri | $21 | $47 | 54 | 12,253 | -3.0% |
| New Mexico | $21 | $26 | 13 | 842 | -3.0% |
| Maine | $21 | $41 | 22 | 2,078 | -3.0% |
| Ohio | $21 | $44 | 44 | 26,641 | -3.6% |
| Wisconsin | $21 | $46 | 50 | 11,597 | -3.6% |
| Louisiana | $21 | $50 | 25 | 4,804 | -3.6% |
| Utah | $21 | $40 | 33 | 1,786 | -3.6% |
| Kentucky | $21 | $45 | 31 | 6,416 | -3.6% |
| South Dakota | $21 | $42 | 12 | 1,312 | -4.0% |
| West Virginia | $21 | $29 | 13 | 2,356 | -4.1% |
| North Carolina | $21 | $44 | 62 | 4,382 | -4.2% |
| South Carolina | $21 | $43 | 60 | 26,249 | -4.2% |
| Iowa | $21 | $41 | 30 | 4,480 | -4.3% |
| Kansas | $21 | $42 | 40 | 8,603 | -4.3% |
| Oklahoma | $21 | $48 | 24 | 8,393 | -4.4% |
| Indiana | $21 | $45 | 52 | 17,988 | -4.5% |
| Tennessee | $21 | $42 | 65 | 7,652 | -4.5% |
| Arizona | $21 | $50 | 52 | 7,037 | -4.6% |
| Alabama | $21 | $41 | 15 | 2,264 | -4.8% |
| Mississippi | $21 | $41 | 26 | 9,899 | -5.4% |
| Idaho | $20 | $26 | 12 | 587 | -6.0% |
| Arkansas | $20 | $88 | 14 | 956 | -8.8% |
⚠️ 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