The Medicare Physician Fee Schedule sets the floor that most commercial payers reference. A 60-minute therapy session (CPT 90837) pays roughly $167 Medicare (non-facility), $185 to $235 commercial, $110 to $150 Medicaid. The full code-by-code table sits below, with locality context and the testing codes that most psychologists undercharge.
Last verified 23 September 2026 · Source: CMS Physician Fee Schedule Look-Up, 2026 final rule (national non-facility amounts)
$173
Medicare 90791 intake (60-90 min)
$167
Medicare 90837 therapy (60 min)
$124
Medicare 96130 testing eval first hour
110-140%
Commercial as multiple of Medicare
CPT-by-CPT Rate Table (2026)
The full set of psychologist-billable CPT codes with the 2026 Medicare PFS national non-facility (office) rate, plus typical Medicaid and commercial ranges. All Medicare rates are the national average before locality (GPCI) adjustment; the office setting is what private-practice psychologists bill.
CPT
Description
Medicare 2026
Medicaid typical
Commercial typical
90791
Psychiatric diagnostic eval (no medical)
$173
$110 - $155
$190 - $240
90832
Psychotherapy, 30 minutes
$86
$55 - $80
$95 - $120
90834
Psychotherapy, 45 minutes
$114
$75 - $105
$125 - $160
90837
Psychotherapy, 60 minutes
$167
$110 - $150
$185 - $235
90839
Crisis psychotherapy, first 60 min
$160
$105 - $145
$175 - $225
90840
Crisis, each additional 30 min
$77
$50 - $70
$85 - $110
90846
Family therapy, patient not present
$106
$70 - $95
$115 - $150
90847
Family therapy, patient present (50 min)
$110
$70 - $100
$120 - $155
90853
Group psychotherapy
$30
$20 - $30
$35 - $45
96130
Psychological testing eval, first hour
$124
$80 - $110
$135 - $175
96131
Psych testing eval, each addl hour
$87
$55 - $80
$95 - $125
96132
Neuropsych testing eval, first hour
$122
$80 - $110
$135 - $170
96133
Neuropsych testing eval, each addl hour
$98
$65 - $90
$110 - $140
96136
Test administration first 30 min (by technician)
$44
$30 - $40
$48 - $62
96137
Test administration, each addl 30 min
$37
$25 - $35
$40 - $52
96146
Single automated test (Q-LES-Q, PHQ-9)
$2.34
$1.50 - $2
$3 - $5
Medicare column: CMS Physician Fee Schedule Look-Up, 2026 national-average non-facility rates from the final rule effective 1 January 2026 (verified 23 September 2026). Locality adjustment ranges roughly minus 8 percent in the lowest-cost areas to plus 23 percent in the highest-cost metros. The Medicaid and commercial columns are typical ranges expressed as multiples of the Medicare rate (Medicaid roughly 65 to 90 percent, commercial roughly 110 to 140 percent); they are illustrative planning ranges, not payer-published fee schedules, and actual contracted rates vary by state and plan.
Worked Example: Typical Insurance Caseload Annual Revenue
Assume a clinician carries 25 sessions per week, 48 working weeks per year, mostly 90837. Three payer mixes, using the 2026 non-facility Medicare rate of $167:
Scenario
Per-session avg
Annual gross (1,200 sessions)
Net after 35% overhead
100% Medicare 90837
$167
$200,400
$130,300
50% Medicare / 50% commercial
~$189
$226,800
$147,400
100% commercial (mid)
~$210
$252,000
$163,800
100% cash-pay ($225)
$225
$270,000
$175,500
Model. Assumes 25 sessions per week x 48 weeks = 1,200 billable units. The commercial figure applies the mid-point of the 110 to 140 percent multiple to the $167 Medicare rate. Overhead 35 percent covers rent, EHR, malpractice, billing, marketing, CE, and unpaid documentation hours. The cash-pay scenario assumes the clinician sets its own rate ($225) and absorbs patient-acquisition cost (currently $80 to $150 per new client through Psychology Today, Headway directory, or paid search), included in the 35 percent overhead.
How the CMS Rate Is Computed
Each CPT code has a Relative Value Unit (RVU) total made of work RVU, practice expense RVU, and malpractice RVU. The total RVU is multiplied by the year's conversion factor and a locality adjustment (Geographic Practice Cost Index, GPCI) to produce the final payment. The 2026 conversion factor is approximately $33.40 per RVU (about $33.57 for clinicians who qualify as advanced alternative-payment-model participants), an increase after several years of cuts. Locality adjustments range from roughly 0.92 in the lowest-cost areas to about 1.23 in the highest-cost metros.
The work RVUs for psychotherapy codes have been a CMS-AMA RUC negotiation point for years, and practice-expense updates in the 2026 rule lifted the office rates for the common therapy codes. Whether that pace continues in the 2027 rule is uncertain. APA Services tracks the annual rule and its effect on psychology.
What does Medicare pay psychologists for a 60-minute therapy session (90837)?
Medicare pays approximately $167 for CPT 90837 (psychotherapy, 60 minutes) in the non-facility (office) setting under the 2026 Physician Fee Schedule, before locality adjustment. Locality-adjusted rates range from roughly $150 in the lowest-cost areas to about $205 in the highest-cost metros. The facility (hospital outpatient) rate is lower, about $135. The 2026 rate reflects the higher conversion factor after several years of cuts. Psychologists in private practice bill the full non-facility rate.
How much does Medicare reimburse for the diagnostic intake 90791?
Medicare reimburses approximately $173 for CPT 90791 (psychiatric diagnostic evaluation without medical services) in the non-facility setting under the 2026 PFS, before locality adjustment. This single-use intake code typically runs 60 to 90 minutes and is billed once per episode of care. Commercial payers usually reimburse the intake at roughly 110 to 140 percent of the Medicare rate, putting commercial 90791 in the $190 to $240 range. Medicaid 90791 rates vary widely by state, generally $110 to $155.
What are the psychological testing CPT codes worth?
Testing has two relevant code pairs. Test administration: 96136 (first 30 minutes by technician) and 96137 (each additional 30 minutes). Test evaluation: 96130 (psychological test evaluation, first hour by psychologist) and 96131 (each additional hour). 2026 Medicare PFS reimburses 96130 at approximately $124 and 96131 at approximately $87 in the non-facility setting. A typical 6-hour neuropsychological battery (intake 90791 + several hours of administration under 96136/37 + several hours of interpretation under 96132/33) Medicare-bills out at roughly $700 to $950 depending on the code mix and locality.
Are commercial insurance rates higher than Medicare for psychologists?
Generally yes, but the gap has narrowed since 2020. Commercial payers (Aetna, Cigna, BCBS, UnitedHealthcare) typically reimburse doctoral psychologists 110 to 140 percent of the Medicare PFS rate. Pre-2020 the multiple was often 150 to 180 percent. Optum (United Behavioral Health) and Cigna Evernorth have been particularly aggressive in narrowing toward Medicare. Anthem and Aetna Behavioral remain closer to the 130 to 140 percent range. Cash-pay clinicians charging $200 to $300 per 90837 session are at roughly 120 to 180 percent of the non-facility Medicare rate.
What is the difference between 90837 (60 min) and 90834 (45 min) reimbursement?
CPT 90834 (psychotherapy, 45 minutes) pays approximately $114 under the 2026 Medicare PFS non-facility rate; CPT 90837 (60 minutes) pays approximately $167. The per-minute rate slightly favours 90837. The clinical and economic decision is whether the additional 15 minutes generates enough therapeutic value to justify the schedule density loss. Many payers have informal soft caps or audit thresholds on 90837 usage above 50 to 60 percent of a clinician's sessions, because the code is among the most-audited psychotherapy codes per Medicare CERT data.
Can psychologists bill 90847 (family/couples therapy)?
Yes. CPT 90847 (family or couples psychotherapy with the patient present, 50 minutes) reimburses approximately $110 under the 2026 Medicare PFS non-facility rate. CPT 90846 (family therapy without the patient present, 50 minutes) reimburses approximately $106. The patient must be identified and the session must focus on that patient's care plan. Many commercial payers reimburse 90847 at slightly higher rates than 90837 (60-min individual) reflecting the additional clinical complexity. Couples therapy as a standalone (no identified patient) is generally not insurance-reimbursable and is typically billed cash.
How do crisis psychotherapy codes 90839 and 90840 pay?
CPT 90839 (psychotherapy for crisis, first 60 minutes) reimburses approximately $160 under the 2026 Medicare PFS non-facility rate. CPT 90840 (each additional 30 minutes) reimburses approximately $77. These codes require documented imminent psychiatric crisis and cannot be used for routine therapy regardless of clinical intensity. Used appropriately, a 90-minute crisis intervention bills at approximately $237 (90839 + 90840), roughly 1.4 times the 90837 rate. These codes are heavily audit-flagged, so documentation of acute crisis criteria (suicidal ideation, severe dissociation, acute psychotic break) must be explicit.
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