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Guide · updated August 2026 · figures from 301 reports

Do counselors get paid less than social workers?

Across 85 reports, licensed professional counselors and mental health counselors reported a median 90837 rate of $110. Licensed clinical social workers reported $117 across 58. Psychologists reported $138 across 10, and marriage and family therapists $113 across 8.

The $7 gap between counselors and social workers is the figure that circulates, and the data supports a narrower claim than the one usually made. Inside each payer, the gap is small, and for the largest payer it runs the other way.

The gap is small, and it flips by payer

Aetna reports put the two licenses at the same $121. Optum reports differ by $2, Cigna by $3 in the counselors' favor, and BCBS by $10 in the counselors' favor. Psychologists are the one group consistently paid more, on samples too small to put a number on with confidence. In other words, commercial payers in this dataset do not appear to pay counselors less than social workers for the same code.

Geography explains most of the overall gap

Counselors are 26% of the dataset's reports, and a large share of them come from Georgia, the state with the lowest 90837 median at $95. Under direct contracts, where the state mix is broader, counselors reported $121 across 45 reports and social workers $116 across 27. Through Headway the two licenses reported $120 and $119. The one route where counselors trail is Grow Therapy, at $84 across 10 reports, and those ten are almost all Georgia rows. Accordingly, the overall $7 gap likely reflects where counselors reported from rather than what payers pay them.

Where the difference is real: Medicare

Medicare is the exception, and it is a recent one. Until January 1, 2024, licensed professional counselors and marriage and family therapists could not bill Medicare at all; the Consolidated Appropriations Act, 2023 added both professions as Medicare providers. Clinical social workers have billed Medicare since 1990. All three professions are paid at 75% of the physician fee schedule amount, while psychologists are paid at 100%. The Medicare guide carries the 2026 dollar figures by code with CMS sources.

That history matters beyond Medicare because commercial payers frequently build their fee schedules as a percentage of Medicare's, and Medicare Advantage plans follow it directly. A profession that entered the fee schedule in 2024 has had two years of contract cycles to be priced in; the data above suggests that, on the codes therapists bill most, it has been.

What this means for reading an offer

Filter the table to your payer and state before you filter to your license. If the counselor and social-worker rows for your payer sit together, the license is not what is moving the offer in front of you. If they sit apart, the reports will show whether the gap is a payer pattern or a handful of rows from one state.

Limitations

These figures have three limitations. First, every rate is self-reported and unverified. Second, license is missing on 53 of 301 rows, and the psychologist and marriage-and-family samples are under ten reports each. Third, the counselor sample is concentrated in Georgia, which is the confound this guide describes rather than one it removes. Nevertheless, the within-payer comparison is the honest one, and it is consistent across the four largest payers.

Every figure above is a community report unless a primary source is linked. The full table · the CSV · add your rate.