99452

Telephone or internet referral service, 30 minutes

Medicare pricing data for 868 providers across 32 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

Telephone or internet referral service, 30 minutes (HCPCS code 99452) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.95, but hospitals typically charge $75.75 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.95, your out-of-pocket cost would be approximately $5.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.95
Average Hospital Charge
$75.75
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$75.75
Medicare Allowed$28.95
Medicare Payment$22.84

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $22.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$35$961731,099+20.7%
Illinois$34$13913245+18.3%
New York$33$7953669+14.9%
Virginia$33$418122+14.0%
Maryland$32$73211,386+11.5%
Missouri$32$94336+11.4%
Delaware$32$110912+10.5%
Kentucky$32$57316+9.6%
South Carolina$32$504160+9.2%
Georgia$32$911076+8.8%
Alabama$31$91223+8.7%
Louisiana$31$753660+8.6%
Arkansas$31$48392+8.0%
Iowa$31$75467+7.7%
Mississippi$31$41483+6.4%
Ohio$31$5331476+5.8%
Pennsylvania$30$11931106+5.0%
Nebraska$30$8885203+4.6%
North Carolina$30$81919+3.6%
Washington$30$7871725+2.5%
Massachusetts$29$86633+0.4%
Texas$29$65431,381-0.6%
Michigan$29$8241270-0.8%
Indiana$28$71826-2.2%
Oregon$28$767217-2.7%
Florida$28$7521955-3.1%
Colorado$28$75192,563-3.2%
Tennessee$28$756836-3.5%
Nevada$28$753610,274-3.7%
Arizona$27$76281,066-5.0%
Utah$27$7510703-6.4%
Idaho$26$7514416-8.5%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber