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Guide · reviewed 2026-10-08

Medicare therapist reimbursement rates for 2026 by CPT code

The table below contains national non-facility reference calculations originally compiled in August 2026. These figures are not a personalized Medicare payment quote. The amount applicable to a claim depends on provider category, locality, setting, service date and payment rules.

Use the CMS Physician Fee Schedule Look-Up Tool and your Medicare Administrative Contractor to check the applicable amount. The labels and comparison guidance on this page were reviewed September 9; the underlying RVU calculations were not recomputed in that review.

National reference calculations for six codes

The 100% column is a national physician fee schedule reference. The 75% column is an arithmetic reference for qualifying provider categories. Neither column establishes the Medicare-only deposit or a patient balance; cost sharing and other claim adjustments can apply. Check telehealth and place-of-service requirements for the actual service.

Sources: CMS relative value files RVU26A (2026) and RVU25A (2025), total non-facility RVUs multiplied by the conversion factor. The 75% figures are computed from the 2026 amounts.

What CMS proposed for 2027

CMS proposed a 2027 national payment of $184.89 for 90837, 10.7% above the 2026 amount, in its proposed rule published July 16, 2026. At 75%, the 90837 reference for clinical social workers, marriage and family therapists and mental health counselors would be $138.67. These are proposed values. The comment period closed September 14, and CMS has not yet released the final rule, which in recent years has arrived in early November.

Calculated by this site from the proposed-rule Addendum B (total non-facility RVUs) multiplied by the proposed conversion factor of $32.8409. CMS does not publish these dollar amounts for proposed rules, and the look-up tool does not carry them.

The conversion factor is proposed to fall 1.68%, from $33.4009 to $32.8409, because a one-year statutory increase for 2026 expires, per the CMS proposed-rule fact sheet. Most psychotherapy codes still rise because their relative value units rise. CMS proposes changing how it allocates practice expense, and its impact analysis states that the proposals "would have a significant positive impact on clinical psychologists and clinical social workers." 2027 is also the fourth and final year of the phased increase to work values for timed behavioral health codes. The intake code, 90791, is roughly flat.

Telehealth rules for mental health hold steady through 2027. Under the Consolidated Appropriations Act, 2026, the in-person visit requirement for mental health telehealth is delayed to January 1, 2028, and audio-only flexibility runs to the same date. The rule proposes no change to the 75% payment level, which is set by statute.

The final rule can change any of these numbers. The proposed practice-expense values for several psychotherapy codes rise more than the 5% annual limit the rule describes for its new stabilization adjustment, and CMS may revise them. This section will be replaced with final 2027 figures once CMS publishes them.

Why the increase is larger than the conversion factor

The 2026 conversion factor rose 3.26%, from $32.35 to $33.40, per the CMS final-rule fact sheet. The psychotherapy codes rose between 6.5% and 9.4% because CMS also revised the practice-expense and malpractice relative value units assigned to them for 2026. Clinicians in a qualifying alternative payment model receive a slightly higher conversion factor of $33.57, which adds under a dollar to a 90837.

Who is paid 75%, and since when

Clinical social workers have billed Medicare since 1990 and are paid at 75% of the physician fee schedule amount for the same service, per CMS's Medicare and Mental Health Coverage guidance. Marriage and family therapists and mental health counselors, which includes licensed professional counselors, became Medicare providers on January 1, 2024 under the Consolidated Appropriations Act, 2023, and are paid at the same 75%, per the CMS MFT and MHC page. All three must accept assignment. Psychologists are paid at 100%.

The 75% comparison applies to eligible, enrolled provider categories. It does not mean every person with a counseling degree is eligible or will receive the listed amount. The license guide explains the categories used in the community data.

Your locality changes the number

CMS applies locality-specific Geographic Practice Cost Indices to the work, practice-expense and malpractice components before the conversion factor. Select the appropriate year, locality and facility or non-facility setting in the official lookup. The applicable provider category and other claim rules still need to be considered.

Comparing Medicare with community reports

The current 90837 table contains clinician-reported payments from commercial insurers, public programs and platforms. Those reports span different states and dates. Medicaid is a public program, and platform payouts can differ from payer allowances. A pooled median compared with a national Medicare reference does not establish Medicare parity for an individual contract.

Limitations

The national calculations omit locality and individual claim adjustments. The underlying RVU arithmetic remains a reference pending a separate versioned calculation review. Commercial and Medicare Advantage terms require their own contract review. Community payment reports are unverified and cannot establish a fee schedule for a particular clinician.

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