Psychiatric collaborative care management per calendar month, each additional 30 minutes
Medicare pricing data for 4,383 providers across 36 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
Psychiatric collaborative care management per calendar month, each additional 30 minutes (HCPCS code 99494) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $53.64, but hospitals typically charge $154.27 — a 2.9x 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 $53.64, your out-of-pocket cost would be approximately $10.73. 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 2.9x more than what Medicare allows for this procedure. Medicare actually pays $42.42 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $64 | $135 | 26 | 259 | +19.5% |
| California | $62 | $192 | 279 | 3,072 | +16.1% |
| Connecticut | $59 | $178 | 59 | 262 | +10.0% |
| Maryland | $59 | $195 | 264 | 2,610 | +9.9% |
| New Jersey | $59 | $138 | 80 | 1,106 | +9.5% |
| Hawaii | $59 | $89 | 1 | 44 | +9.4% |
| Massachusetts | $58 | $171 | 221 | 880 | +8.0% |
| Maine | $58 | $254 | 12 | 45 | +7.7% |
| Delaware | $57 | $94 | 7 | 77 | +5.9% |
| Virginia | $57 | $147 | 116 | 1,229 | +5.4% |
| Vermont | $56 | $198 | 2 | 63 | +4.4% |
| Washington | $55 | $159 | 192 | 1,001 | +2.0% |
| Oklahoma | $54 | $136 | 46 | 177 | +1.3% |
| Arizona | $53 | $108 | 377 | 2,984 | -0.9% |
| North Carolina | $53 | $113 | 101 | 1,004 | -1.1% |
| Pennsylvania | $53 | $126 | 294 | 3,629 | -1.3% |
| New Mexico | $53 | $153 | 12 | 37 | -1.7% |
| Montana | $53 | $139 | 56 | 366 | -2.0% |
| South Carolina | $52 | $150 | 66 | 344 | -2.2% |
| Michigan | $52 | $131 | 214 | 4,046 | -2.6% |
| Minnesota | $52 | $124 | 85 | 709 | -2.6% |
| Missouri | $52 | $134 | 146 | 647 | -3.4% |
| New York | $52 | $195 | 247 | 6,477 | -3.7% |
| West Virginia | $52 | $176 | 9 | 41 | -3.7% |
| Texas | $52 | $161 | 246 | 1,539 | -3.7% |
| Florida | $52 | $124 | 349 | 2,861 | -3.8% |
| Ohio | $52 | $125 | 107 | 623 | -3.8% |
| Colorado | $51 | $136 | 111 | 631 | -4.0% |
| Tennessee | $51 | $120 | 20 | 443 | -4.7% |
| Illinois | $51 | $158 | 151 | 660 | -4.9% |
| Wisconsin | $50 | $196 | 187 | 1,052 | -6.0% |
| Arkansas | $49 | $120 | 62 | 313 | -8.6% |
| Georgia | $48 | $200 | 73 | 1,199 | -9.7% |
| Utah | $47 | $123 | 60 | 118 | -12.8% |
| Oregon | $45 | $156 | 25 | 132 | -16.6% |
| Idaho | $40 | $90 | 22 | 355 | -26.2% |
⚠️ 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