How we calculated this
Every figure on this page is a ballpark, rounded to the nearest $5,000, for a panel with a mix of Medicare, Medicaid, and commercial patients. We anchor the arithmetic to public 2026 Medicare rates because they sit between the two: Medicaid generally pays less, commercial plans generally pay more. Nurse practitioners bill under their own NPI at 85% of the physician fee schedule, across a set number of visits per week over 48 weeks a year, which leaves four weeks for holidays and time off.
Every figure assumes a mix of 15% new-patient level-4 visits (99204) and 85% established-patient level-4 visits (99214), with a 30-minute psychotherapy add-on (90833) on every new-patient visit and just over half of established visits. The weekly volumes assume about eight visits a day, fewer than a primary care day because psychiatric visits run longer. Medicare payments come from the 2026 physician fee schedule: each code's relative value units, adjusted by the Massachusetts geographic indices, times the 2026 conversion factor of $33.4009. Massachusetts has more than one Medicare payment locality and we average them into a single statewide figure. The annual figures are estimates of practice earnings before tax, benefits, and office rent. With Kinstead you're paid per visit, so what you take home doesn't swing with what a given payer decides to pay or how quickly they pay it.
These are estimates, not a guarantee, an offer, or legal, tax, or financial advice. Individual results vary with payer mix, panel size, no-show rate, and how the practice is run.
2026 Medicare payments behind these estimates
| Visit type | Massachusetts |
|---|---|
| New patient, level 4 (99204) | about $189 |
| Established patient, level 4 (99214) | about $145 |
| Psychotherapy add-on, 30 min (billed with a visit) (90833) | about $85 |
Approximate statewide physician fee-schedule amounts. Nurse practitioners bill 85% of them, which the estimates already account for.