It’s been a while since I reported about this. Given that hospitals and now insurance companies are required to publicly report their charges including cash prices for uninsured consumers and negotiated reimbursement, and especially in the context of current needs for access and care, maybe it’s time for mental health clinicians to increase transparency. What do we know about prices? Here’s one look.
In theory, psychologists charge patients who have Medicare the same amount as they would charge patients who have other insurance, or no insurance. In practice, actual charges may differ depending on individual patient context and clinician policy. Neverthless, charges submitted to Medicare likely provide a reasonable estimate of psychologist charges generally because these occur in a large population (61.5 million in 2020, Kaiser Family Foundation), and for very large numbers of services.
The following summarizes information from all charges submitted by psychologists to Medicare in 2020, the most recent year for which data are publicly available at Data.CMS.gov.
Average charges are shown by state for an initial evaluation (90791), for a 60 minute therapy session (90837, technically 53 minutes or more), for a 45 minute session (90834, technically a 38-52 minute session), and for a 30 minute session (90832, technically 16-37 minutes).
Data represent 5,278 psychologists billing Medicare in 2020 (though not all billed all of these services), and 336,691 units of 90791, 1,574,449 units of 90837, 1,398,186 units of 90834, and 942,206 units of 90832. Together, these four services accounted for 73% of all units of service provided to Medicare beneficiaries by psychologists in 2020.
AVERAGE PSYCHOLOGIST CHARGES BY STATE
PR = Puerto Rico. VI = Virgin Islands
Average charges in a facility setting such as a hospital are consistently higher than when the service is provided in an office setting.
How do psychologist charges compare to other mental health clinicians’ charges?
Here is a comparison of average submitted charges among licensed clinical social workers, clinical psychologists, and psychiatrists. Values reflect 8,729 LCSWs, 5,278 psychologists, and 3,591 psychiatrists billing Medicare in 2020. Not all clinicians billed all of these services.