Specialty rate rollup
Behavioral Health
Psychological assessment, psychotherapy, and group treatment, the core non-prescribing behavioral-health service mix.
This is a curated starter set for comparison. It doesn't claim that every specialty bills every code, and it isn't a utilization-weighted average.
At a glance
Q2 2018 compared with the prior available PFS release.
Conversion factor: 0.0% no change
Payable codes
5 / 5
Changed this release
0
Largest increase
None
Largest decrease
None
See the rates where you practice
Enter a ZIP code to apply that Medicare locality’s work, practice-expense, and malpractice adjustments to every row.
Current national rates Copy link
Q2 2018 releaseOffice (non-facility) and facility professional amounts, GPCI 1.000, before sequestration.
| Code and service | Status | Office (non-facility) | Facility |
|---|---|---|---|
| Visits and evaluation | |||
| 90791 Psychiatric Diagnostic Evaluation | Active |
$136.44
No price history
|
$128.16
No price history
|
| Treatment and ongoing management | |||
| 90832 Brief Therapy Session | Active |
$66.24
No price history
|
$63.72
No price history
|
| 90834 Standard Therapy Session | Active |
$88.56
No price history
|
$84.96
No price history
|
| 90837 Extended Therapy Session | Active |
$132.84
No price history
|
$127.80
No price history
|
| 90853 | Active |
$26.64
No price history
|
$25.20
No price history
|
Every code links to its contracted-rate (% of Medicare) table and a full RVU breakdown, plus billing-policy context and rate history.
How often these codes appear in Medicare Copy link
Across Original Medicare nationally in CY2024, the covered codes on this page accounted for the activity below. It counts use by clinicians of every specialty, not just Behavioral Health, and CMS publishes it on a different cycle from the fee schedule.
Services
13.5M
Times these codes were billed
Allowed dollars
$1.4B
Across covered Medicare FFS services
Most used in this set
90837
6.9M services
Coverage: 5 of 5 displayed codes. HCPCS Level II and excluded drug codes may not appear in this utilization dataset.
What this specialty actually bills Medicare
Observed CY2024 Medicare fee-for-service billing by Behavioral Health clinicians, grouped by CMS rendering-provider specialty. That grouping differs from this page's Behavioral Health label, so treat it as context for the curated list above.
| Top codes by allowed dollars | Share of allowed | Allowed |
|---|---|---|
| 90837 | 48.8% | $454.8M |
| 90834 | 18.3% | $170.1M |
| 90832 | 12.2% | $113.2M |
| 90791 | 8.0% | $74.1M |
| 96133 not in the list above | 3.7% | $34.4M |
| 96132 not in the list above | 2.0% | $18.8M |
| 96139 not in the list above | 1.3% | $11.9M |
| 96137 not in the list above | 1.1% | $10.4M |
| 96116 not in the list above | 0.8% | $7.2M |
| 96130 | 0.6% | $6.1M |
| Top codes by services | Share of services | Services |
|---|---|---|
| 90837 | 35.8% | 3.6M |
| 90834 | 19.4% | 1.9M |
| 90832 | 17.2% | 1.7M |
| 90791 | 5.0% | 503,152 |
| 96133 not in the list above | 3.7% | 371,684 |
| 96139 not in the list above | 3.4% | 344,132 |
| 96137 not in the list above | 2.9% | 295,334 |
| 90785 not in the list above | 2.9% | 291,249 |
| 90853 | 1.8% | 181,002 |
| 96132 not in the list above | 1.5% | 155,103 |
Localis can price 84% of this cohort's observed services (89% of allowed dollars) under the Q2 2018 release. The rest is clinical lab, drugs, or services paid outside the PFS under other fee schedules, not $0.
Also high-volume for this cohort (observed, not yet in the curated list above)
This is observed billing only. The curated table above is still this page's rate list.
CY2024 Medicare fee-for-service only. Codes billed by fewer than 30 observed clinicians in a single setting are not shown, so shares may not total 100%. CMS publishes only a facility vs non-facility split, not exact places of service. Observed use adds context to the curated table above. It doesn't weight or change any rate on this page.
Turn the list into contract math
Analyze a payer offer using these Behavioral Health codes
We’ll preload the code set in Contract Check. Add your annual volumes and ZIP to see the volume-weighted percentage of Medicare and annual-dollar difference.
Get notified when Behavioral Health rates change
Medicare updates the fee schedule every quarter. We'll email you only when a release moves one of the 7 Behavioral Health codes on this page.
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Source & method Copy link
Amounts are computed from the CMS Medicare Physician Fee Schedule Q2 2018 release, GPCI 1.000, before the ~2% sequestration cut. The grouping by common clinical scenario is our own, not the AMA’s code-family taxonomy, and it’s a curated starter set, not a utilization-weighted specialty mix. A code with no amount is either not separately payable under the PFS or absent from the release. It never means $0.