Home›Guides›Medicare 90837 by locality

Guide · reviewed 2026-11-12

How much Medicare pays for 90837 in 2026 and 2027, by state and locality

Medicare pays $167.00 for a 60-minute psychotherapy session (CPT 90837) in 2026 and $183.37 in 2027, as national amounts at the full fee schedule rate. No clinician is paid the national amount. Each of Medicare's 109 payment localities has its own figure, and in 2027 they run from $168.68 in Arkansas to $222.75 in San Jose-Sunnyvale-Santa Clara (San Benito County), with Alaska at $249.99.

Clinical social workers, marriage and family therapists and mental health counselors are paid 75% of the amount. Nurse practitioners and physician assistants are paid 85%. Psychologists and physicians are paid 100%. The table below gives all three for 2027.

The 2027 increase is 4.8% in some places and 12.3% in others

The national 90837 amount rises 9.8% in 2027. The increase by locality runs from 4.8% in Arkansas to 12.3% in San Jose-Sunnyvale-Santa Clara (Santa Clara County). Two things in the CMS files account for the spread.

First, the floor on the work adjustment ends. Through 2026, a locality whose work index fell below 1.0 was raised to 1.0. The 2027 CMS index file states that this floor "was extended through January 1, 2027" and that "the work GPCIs for 2027 do not reflect a 1.0 floor." In 2027, 49 of the 109 localities have a work index below 1.0, so clinicians there receive less of the national increase.

Second, most of the 2027 increase for 90837 sits in practice expense, which goes from 1.20 to 1.66 relative value units while work goes from 3.78 to 3.94. Practice expense is multiplied by the locality's practice-expense index, which is above 1.0 in high-cost areas and below it in low-cost ones. A larger practice-expense share widens the gap between them. The 2027 briefing covers why the values moved.

90837 by Medicare locality

Find your state, then your locality. Most states are a single locality. California, New York, Texas and several others are divided, and the CMS look-up tool will tell you which one a ZIP code falls in.

Calculated by this site with the formula CMS publishes: (work RVU × work index + practice-expense RVU × practice-expense index + malpractice RVU × malpractice index) × conversion factor. RVUs and conversion factors are from the CMS relative value files RVU26A and RVU27A; the indices are from the GPCI2026 and GPCI2027 files in the same downloads. The 2026 column uses the work index with the 1.0 floor and the $33.4009 conversion factor. The 2027 column uses the work index without the floor and the $32.6286 conversion factor, both for clinicians outside a qualifying alternative payment model. Non-facility setting. The 85% and 75% columns are computed from the 2027 amount.

What these amounts are and are not

Each figure is the Medicare fee schedule amount for the service. Medicare pays 80% of it after the Part B deductible and the patient or a supplemental plan owes the rest, so the deposit from Medicare alone is smaller. Medicare Advantage plans set their own contracted rates. A session billed from a facility is paid at a lower facility rate.

For what commercial payers pay for the same code, see reported 90837 rates. For the other psychotherapy, office-visit and testing codes at the national level, see the Medicare guide.

Limitations

This table has three limitations. First, the amounts are this site's arithmetic from CMS's published inputs; CMS's own look-up tool is the authority, and a cent of rounding difference is possible. Second, the 2027 column assumes the work floor is not extended again. Congress has extended it before, and a new extension would raise the 2027 figure in the 49 localities below 1.0. Third, the table covers one code in one setting. Nevertheless, the inputs are final and public, and the spread is large enough to check before deciding whether a Medicare panel is worth joining in a given locality.

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