Guide · updated August 2026 · figures from 301 reports
Medicare therapist reimbursement rates for 2026 by CPT code
Medicare's 2026 national non-facility payment for CPT 90837 is $167.00, up from $154.29 in 2025. Clinical social workers, licensed professional counselors, mental health counselors, and marriage and family therapists are paid 75% of that amount, or $125.25. Psychologists are paid the full amount. The figures below come from the CMS relative value files and the 2026 final rule.
Medicare is the one fee schedule that is published in full, which makes it the benchmark commercial payers and therapists both refer to. The therapist-reported commercial median for a 90837 on this site is $114 across 202 reports, which is below what Medicare pays a social worker for the same session in 2026.
The 2026 rates, all seven codes
National non-facility amounts, which apply to office and telehealth sessions billed from a non-facility location. The 100% column is what psychologists (and physicians) receive; the 75% column is what social workers, counselors, and marriage and family therapists receive.
| Code | Service | 2025 (100%) | 2026 (100%) | 2026 at 75% | Change |
|---|---|---|---|---|---|
| 90791 | Diagnostic evaluation (intake) | $166.91 | $173.35 | $130.01 | +3.9% |
| 90832 | Psychotherapy, 30 min | $78.93 | $85.84 | $64.38 | +8.8% |
| 90834 | Psychotherapy, 45 min | $104.16 | $113.90 | $85.43 | +9.4% |
| 90837 | Psychotherapy, 60 min | $154.29 | $167.00 | $125.25 | +8.2% |
| 90846 | Family therapy, client absent | $98.66 | $105.88 | $79.41 | +7.3% |
| 90847 | Family therapy, client present | $102.86 | $109.55 | $82.16 | +6.5% |
Sources: CMS relative value files RVU26A (2026) and RVU25A (2025), total non-facility RVUs multiplied by the conversion factor. Third-party fee-schedule lookups report the same dollar amounts. The 75% figures are computed from the 2026 amounts.
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%.
In practice, a licensed counselor and a clinical social worker billing Medicare for a 90837 in 2026 both receive $125.25 before the locality adjustment. The license guide compares that with what commercial payers are reported to pay each profession.
Your locality changes the number
The national amount is the sum of three relative value units, for work, practice expense, and malpractice, multiplied by the conversion factor. The amount paid in a specific locality multiplies each of those components by that locality's Geographic Practice Cost Index before applying the conversion factor, so a session in Manhattan pays more than the national figure and a session in rural Alabama pays less. The CMS Physician Fee Schedule Look-Up Tool returns the exact amount for any code and locality; select the non-facility price and your Medicare Administrative Contractor's locality.
Medicare against what therapists report from commercial payers
For a 90837, the 75% Medicare amount of $125.25 sits above the reported commercial medians for every payer except the highest Medicaid rows: Aetna $121, BCBS $120, Optum $116, Cigna $97 across the reports on this site. Reported commercial intake (90791) rates run closer to Medicare's $130.01, with direct-contract Aetna intakes at $144 and Headway's at $124. Given that commercial fee schedules are often expressed as a percentage of Medicare, a commercial 90837 rate below $125 is, for a master's-level clinician, a rate below Medicare parity. The 90837 page shows every reported rate against that line.
Limitations
These figures have three limitations. First, the national amounts are before the locality adjustment, which moves them by roughly ten percent in either direction. Second, the 75% figures are computed, and CMS rounds at the claim level, so an individual remittance may differ by cents. Third, the commercial comparisons on this page are community-reported and unverified. Nevertheless, the Medicare amounts are the only published rates in the field, and they anchor every other number on this site.
Every figure above is a community report unless a primary source is linked. The full table · the CSV · add your rate.