90834

Psychotherapy, 45 minutes

Medicare pricing data for 56,899 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 3.4 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Psychotherapy, 45 minutes (HCPCS code 90834) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $85.24, but hospitals typically charge $170.08 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.05

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $85.24, your out-of-pocket cost would be approximately $17.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$85.24
Average Hospital Charge
$170.08
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$170.08
Medicare Allowed$85.24
Medicare Payment$65.18

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $65.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$118$240923,796+38.0%
California$96$1953,756250,067+13.0%
Hawaii$92$1881733,069+7.4%
New York$90$1736,566736,821+5.8%
Puerto Rico$90$1011352,089+5.7%
District of Columbia$88$16915710,768+3.7%
New Jersey$88$1762,439223,180+3.2%
Illinois$87$1642,483156,688+2.6%
Washington$87$19392131,250+2.5%
Arizona$87$17149120,354+2.4%
Pennsylvania$86$1522,483135,456+0.9%
Texas$86$1591,834159,857+0.7%
Colorado$85$1791,16132,368-0.2%
Florida$85$1702,313126,338-0.5%
Delaware$83$15125614,973-2.7%
New Hampshire$83$15757643,689-2.8%
Oregon$83$20882822,913-3.0%
Nevada$82$1642447,719-3.5%
Connecticut$82$1821,35565,769-3.8%
Massachusetts$82$1693,926320,972-3.9%
Ohio$82$1642,04357,009-3.9%
Maryland$81$1521,903149,744-4.5%
New Mexico$81$14635311,933-4.6%
South Carolina$81$15544313,354-5.2%
Georgia$81$17372632,818-5.4%
Virginia$81$1491,26872,235-5.5%
South Dakota$80$1611895,336-5.6%
Rhode Island$80$15544120,044-5.7%
Vermont$80$14731518,250-5.7%
Minnesota$80$2331,93668,354-5.8%
Missouri$80$14885649,891-5.9%
Montana$80$1732435,382-6.2%
West Virginia$80$1652535,703-6.2%
North Dakota$80$20125310,783-6.5%
Tennessee$80$15364033,401-6.5%
Utah$79$17147210,898-6.8%
Kansas$79$14858824,682-7.4%
Michigan$79$1533,237111,519-7.4%
Mississippi$79$1731543,620-7.6%
Wyoming$78$1681224,613-7.9%
North Carolina$78$1711,50047,848-8.1%
Wisconsin$77$2361,24953,883-9.4%
Indiana$76$1461,25953,534-10.6%
Alabama$76$1492854,649-10.6%
Nebraska$76$17433015,732-10.6%
Louisiana$76$15737312,392-11.1%
Kentucky$75$16064213,518-11.6%
Iowa$74$16474332,827-12.7%
Oklahoma$74$12940932,654-12.7%
Arkansas$74$1464669,867-13.2%
Maine$74$13261814,318-13.7%
Idaho$73$14537617,983-14.8%

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

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