For calendar year 2026, Medicare's national non-facility amounts are $173.35 for 90791, $85.84 for 90832, $113.90 for 90834, $167.00 for 90837 and $109.55 for 90847, using CMS's nonqualifying-APM conversion factor of $33.4009. Your actual amount depends on locality, setting and license type.
Last verified: November 9, 2026.
General information, not financial or legal advice. Figures below are calculated from CMS public files as of November 9, 2026. Medicare rates change at least once a year, and commercial and Medicaid payers set their own rates.
Where these numbers come from
Every rate on this page is calculated from one primary source: the CMS CY 2026 National Physician Fee Schedule Relative Value File, October release (RVU26D), released August 26, 2026, and its geographic adjustment file (GPCI2026). We used the formula CMS publishes on its PFS documentation page:
Non-facility amount = [(Work RVU × Work GPCI) + (Non-facility PE RVU × PE GPCI) + (MP RVU × MP GPCI)] × conversion factor
For a national amount, every GPCI is 1.000, so the amount is simply the total RVUs times the conversion factor.
Two conversion factors in 2026. The CY 2026 final rule created separate conversion factors for qualifying APM participants (QPs) and everyone else. The CMS fact sheet rounds them to $33.57 and $33.40. The RVU files carry the exact values: $33.5675 for QPs and $33.4009 for non-QPs. Most solo and small-group therapy practices are not QPs, so the tables below lead with the non-QP figure.
We did not use third-party rate sites or survey averages. If a number here does not match a figure you saw elsewhere, check the year, locality and conversion factor that source used.
2026 national Medicare rates for common psychotherapy codes
CPT descriptors are copyrighted by the AMA, so the "What it covers" column is our own plain-language summary. The CMS short descriptor from the RVU file is in quotes.
| Code | What it covers | CMS short descriptor | Total RVUs (non-facility / facility) | Non-QP non-facility | Non-QP facility | QP non-facility |
|---|---|---|---|---|---|---|
| 90791 | Initial psychiatric diagnostic evaluation, no medical services | "Psych diagnostic evaluation" | 5.19 / 4.11 | $173.35 | $137.28 | $174.22 |
| 90832 | Individual psychotherapy, about 30 minutes with the patient | "Psytx w pt 30 minutes" | 2.57 / 2.08 | $85.84 | $69.47 | $86.27 |
| 90834 | Individual psychotherapy, about 45 minutes | "Psytx w pt 45 minutes" | 3.41 / 2.75 | $113.90 | $91.85 | $114.47 |
| 90837 | Individual psychotherapy, about 60 minutes | "Psytx w pt 60 minutes" | 5.00 / 4.05 | $167.00 | $135.27 | $167.84 |
| 90847 | Family psychotherapy with the patient present | "Family psytx w/pt 50 min" | 3.28 / 3.08 | $109.55 | $102.87 | $110.10 |
Three related codes practices often ask about:
90792 (diagnostic evaluation with medical services, used by prescribers): 6.05 non-facility RVUs, $202.08 non-QP national.
90846 (family psychotherapy without the patient): 3.17 RVUs, $105.88. The RVU file gives it status "R" (restricted coverage), so check your MAC's policy before relying on it.
90853 (group psychotherapy, per patient): 0.91 RVUs, $30.39.
Non-facility vs. facility. The non-facility amount applies when you bill from your own office. The facility amount, lower because the facility is paid separately for overhead, applies when the service is in a hospital or similar facility setting.
What you actually receive depends on your license
The table shows the full Medicare fee schedule amount. Two more rules decide what lands in your account.
1. License type. CMS's Medicare & Mental Health Coverage booklet (MLN1986542, March 2026) and its MFT and MHC page set these payment levels:
| Clinician | Medicare payment basis | 90837 national non-QP example |
|---|---|---|
| Psychiatrist or other physician | 100% of the fee schedule amount | $167.00 |
| Clinical psychologist | 100% of the fee schedule amount, only with assignment | $167.00 |
| Clinical social worker (CSW) | 75% of the clinical psychologist amount | $125.25 |
| Marriage and family therapist (MFT) | 75% of the clinical psychologist amount | $125.25 |
| Mental health counselor (MHC) | 75% of the clinical psychologist amount | $125.25 |
| Nurse practitioner or PA | 85% of the physician amount | $141.95 |
The 75% and 85% figures are simple percentages of the $167.00 national amount, rounded to cents. MFTs and MHCs have been able to bill Medicare on their own since January 1, 2024.
2. The patient's share. Medicare Part B generally pays 80% of the allowed amount after the Part B deductible, and the patient owes the rest. For a physician or psychologist billing 90837 at the national non-facility rate, that is $133.60 from Medicare and $33.40 from the patient. Supplemental coverage may pay the patient's part. The MLN booklet says clinical psychologists, CSWs, MFTs and MHCs must accept assignment, so they cannot bill the patient above the Medicare amount.
How much rates vary by locality
Medicare adjusts each RVU component with a geographic practice cost index (GPCI). For psychotherapy codes most of the RVUs are work RVUs, and the work GPCI has a 1.0 floor in 2026. Rates still differ by locality, though less than for codes with heavy practice-expense weight.
Non-QP, non-facility, from GPCI2026:
| Locality (number) | 90834 | 90837 | 90791 |
|---|---|---|---|
| Alabama, statewide (00) | $110.14 | $161.70 | $167.51 |
| Rest of Texas (99) | $112.42 | $164.90 | $171.02 |
| Chicago, IL (16) | $115.50 | $168.95 | $175.34 |
| Miami, FL (04) | $116.06 | $169.67 | $176.19 |
| Manhattan, NY (01) | $124.25 | $181.97 | $189.15 |
| San Francisco–Oakland–Berkeley, CA (05) | $133.00 | $195.05 | $203.36 |
The worked example for Manhattan is in how to use the Medicare fee schedule lookup for psychotherapy codes.
One 2026 policy that did not cut psychotherapy
The CY 2026 final rule added a −2.5% "efficiency adjustment" to work RVUs for many services. The CMS fact sheet says it applies to all codes except time-based codes, and it lists "behavioral health services" among the exemptions. Medicare's psychotherapy rates rose in 2026 mainly because of the conversion factor increase, not because of any change specific to psychotherapy. Confirm the exemption list in the final rule if a code you bill is unusual.
How practices set self-pay fees
Medicare rates are a public, documented reference point, but they are not a price list for private-pay therapy. Practices usually combine four inputs. None of them is a formula we can recommend for your practice.
1. Your cost floor
Add up a year of practice costs: rent, EHR and telehealth software, malpractice coverage, licensing and CE, billing, marketing, and the clinician's target pay. Divide by the number of clinical hours you can realistically fill. That hourly figure is the lowest fee that keeps the practice solvent. Only your own books can produce this number.
2. What payers already pay you
If you are in-network, your EOBs and contract rate exhibits show your actual allowed amounts for each code. Comparing your self-pay fee with those allowed amounts helps you explain why the two differ. Our guide to insurance carriers, allowed amounts and out-of-network reimbursement shows where to find them. For Medicaid, see the state behavioral health fee schedule your Medicaid agency publishes.
3. Published local fees
Many practices publish self-pay fees on their own websites. Reading the pricing pages of clinicians near you with similar licenses is a legitimate market check. It is first-hand evidence, unlike aggregator "average cost" figures, which rarely say how they were collected.
4. Access commitments
Sliding scales, a set number of reduced-fee slots, or package pricing for intensive programs are policy choices. Whatever you choose, write the policy down and apply it consistently.
Rules that apply whatever you charge
Good faith estimates. Uninsured and self-pay patients have a right to a good faith estimate under the No Surprises Act rules. See good faith estimates and your practice website.
Medicare patients. Separate Medicare rules govern whether you can charge a Medicare beneficiary privately at all: opt-out, assignment and limiting charges. Read the MLN booklet before setting a cash fee for Medicare patients.
Antitrust caution. Comparing published fees is normal. Agreeing on fees with competing practices is not. Keep fee decisions inside your own practice.
Publishing what you charge
Patients searching "how much does therapy cost" want a number. Clinics that state self-pay fees or name the plans they accept answer that question before the first call. The free ClinicStats audit includes an "Insurance or self-pay prices stated" check (described on our methodology page). It shows whether your site names plans or prices, and the same report checks whether AI assistants can read your pages. To build the page itself, see how to build a therapy pricing page. Run a free scan of your site to see where you stand.