99492

Initial psychiatric collaborative care management, first calendar month, first 70 minutes

Medicare pricing data for 5,068 providers across 39 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

Initial psychiatric collaborative care management, first calendar month, first 70 minutes (HCPCS code 99492) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $137.13, but hospitals typically charge $352.27 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $137.13, your out-of-pocket cost would be approximately $27.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$137.13
Average Hospital Charge
$352.27
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$352.27
Medicare Allowed$137.13
Medicare Payment$106.14

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $106.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$162$5033671,339+17.8%
District of Columbia$160$34726130+16.6%
New Jersey$153$37184309+11.2%
Maryland$151$497249808+10.5%
Maine$149$5871523+8.4%
Massachusetts$145$4403471,087+5.5%
Connecticut$144$38865192+4.8%
Texas$141$2242752,396+2.6%
Washington$139$386223459+1.2%
New York$137$3752653,844+0.2%
Virginia$137$293114667+0.1%
Delaware$137$2161339-0.1%
Montana$136$33344143-0.5%
Arizona$136$3324141,818-0.9%
Minnesota$136$20273641-1.1%
Florida$135$3053851,741-1.2%
South Carolina$135$35277200-1.5%
Illinois$134$422167307-2.5%
Ohio$133$298126258-3.0%
North Carolina$132$343125230-3.7%
Missouri$132$308160320-3.7%
New Mexico$132$3741631-3.9%
Colorado$130$331139344-5.3%
Indiana$130$321515-5.4%
Michigan$129$292237793-5.7%
Arkansas$129$30065104-6.0%
Pennsylvania$129$4053411,392-6.2%
Wisconsin$127$456220861-7.1%
Oklahoma$125$21364289-8.6%
Tennessee$125$25828264-8.8%
Georgia$125$384791,014-8.8%
Vermont$121$291688-12.0%
Utah$120$260116178-12.7%
Oregon$118$3983056-13.8%
West Virginia$117$365913-14.4%
New Hampshire$111$3172141-19.2%
Louisiana$105$449211-23.1%
Kentucky$105$274913-23.6%
Idaho$97$2001232-29.5%

⚠️ 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