Psychotherapy with evaluation and management visit, 45 minutes
Medicare pricing data for 9,326 providers across 52 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
Psychotherapy with evaluation and management visit, 45 minutes (HCPCS code 90836) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $85.80, but hospitals typically charge $170.59 — a 2.0x 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 $85.80, your out-of-pocket cost would be approximately $17.16. 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 2.0x more than what Medicare allows for this procedure. Medicare actually pays $66.35 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $108 | $262 | 37 | 961 | +26.2% |
| New York | $92 | $171 | 1,147 | 99,612 | +7.1% |
| California | $89 | $199 | 900 | 55,430 | +3.9% |
| District of Columbia | $89 | $149 | 47 | 3,018 | +3.2% |
| New Jersey | $87 | $174 | 300 | 22,634 | +1.4% |
| Pennsylvania | $86 | $146 | 304 | 18,299 | +0.6% |
| Massachusetts | $86 | $182 | 656 | 42,454 | -0.3% |
| Connecticut | $85 | $157 | 177 | 8,214 | -1.0% |
| Illinois | $84 | $152 | 320 | 12,170 | -1.6% |
| Puerto Rico | $84 | $94 | 16 | 129 | -1.7% |
| Maryland | $84 | $142 | 334 | 18,601 | -1.9% |
| Virginia | $83 | $150 | 199 | 5,082 | -3.6% |
| Washington | $82 | $157 | 248 | 7,466 | -4.3% |
| Michigan | $82 | $147 | 239 | 6,004 | -4.4% |
| Florida | $82 | $178 | 568 | 14,700 | -4.6% |
| Missouri | $82 | $135 | 79 | 3,154 | -5.0% |
| Vermont | $81 | $146 | 38 | 1,492 | -5.1% |
| Hawaii | $81 | $179 | 69 | 2,953 | -5.1% |
| Rhode Island | $81 | $142 | 96 | 2,879 | -6.0% |
| Georgia | $81 | $194 | 181 | 3,942 | -6.1% |
| Texas | $80 | $156 | 398 | 9,331 | -6.2% |
| Ohio | $80 | $147 | 317 | 6,184 | -6.6% |
| Maine | $80 | $145 | 50 | 1,964 | -6.9% |
| Wisconsin | $79 | $212 | 120 | 2,237 | -7.5% |
| Wyoming | $79 | $155 | 9 | 168 | -8.1% |
| New Hampshire | $79 | $156 | 68 | 1,795 | -8.2% |
| North Carolina | $79 | $159 | 263 | 6,472 | -8.3% |
| Indiana | $78 | $164 | 48 | 1,130 | -8.6% |
| South Carolina | $78 | $156 | 124 | 3,161 | -8.7% |
| Colorado | $78 | $201 | 202 | 3,781 | -8.8% |
| Oregon | $78 | $194 | 195 | 4,907 | -8.9% |
| Arizona | $78 | $161 | 222 | 9,136 | -9.0% |
| Louisiana | $78 | $151 | 87 | 1,309 | -9.3% |
| New Mexico | $78 | $141 | 53 | 1,853 | -9.4% |
| Utah | $78 | $161 | 68 | 1,107 | -9.6% |
| Alabama | $77 | $134 | 74 | 1,201 | -9.8% |
| Delaware | $76 | $169 | 47 | 1,041 | -11.1% |
| West Virginia | $76 | $140 | 18 | 174 | -11.1% |
| North Dakota | $76 | $177 | 17 | 280 | -11.2% |
| Montana | $76 | $189 | 38 | 484 | -11.3% |
| Minnesota | $76 | $210 | 162 | 2,276 | -11.4% |
| Kentucky | $76 | $177 | 108 | 1,199 | -11.5% |
| Oklahoma | $75 | $174 | 56 | 1,274 | -12.2% |
| Tennessee | $75 | $145 | 148 | 3,281 | -12.6% |
| Kansas | $75 | $148 | 52 | 1,120 | -12.7% |
| Idaho | $74 | $147 | 49 | 821 | -14.1% |
| Mississippi | $74 | $164 | 52 | 686 | -14.3% |
| South Dakota | $73 | $190 | 10 | 270 | -15.0% |
| Iowa | $73 | $185 | 76 | 956 | -15.0% |
| Nevada | $72 | $132 | 79 | 3,165 | -15.9% |
| Nebraska | $70 | $207 | 60 | 742 | -18.6% |
| Arkansas | $69 | $160 | 66 | 933 | -19.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber