CPT Code Reimbursement Calculator for Therapists
Estimate insurance reimbursement for psychotherapy CPT codes like 90834, 90837, and 90791. Build a typical week of sessions, set your payer mix, and watch your estimated practice revenue print out - by week, month, and year.
1Build a typical week
21 sessions · 18.0 hrsTap + to add the sessions you run in an average week. Know your contracted rate? Click any dollar amount to use it instead of our estimate.
2Who pays you?
Drag the sliders to match your caseload. Whatever's left is self-pay.
3Reality check
Based on 2026 Medicare national non-facility rates. Estimates only - actual contracts vary by payer, state & locality.
2026 Medicare rates used in this calculator
Non-QP national non-facility rates from the CMS Medicare Physician Fee Schedule (RVU26C, July 2026), rounded. Your locality's rates will differ slightly based on geographic adjustment (GPCI). New to these codes? The mental health CPT code reference covers what each one means, its time range, and why claims get denied.
| CPT code | Service | Medicare national rate (non-QP) |
|---|---|---|
| 90791 | Psychiatric diagnostic evaluation - the first appointment. | $173.35 |
| 90832 | Individual psychotherapy, 30 minutes. | $85.84 |
| 90834 | Individual psychotherapy, 45 minutes - the standard outpatient session. | $113.90 |
| 90837 | Individual psychotherapy, 60 minutes. | $167.00 |
| 90846 | Family psychotherapy without the client present. | $105.88 † |
| 90847 | Family or couples psychotherapy with the client present. | $109.55 |
| 90853 | Group psychotherapy, per participant. | $30.39 |
† 90846 has restricted Medicare coverage (status indicator R) and is contractor-priced when covered, so its amount is an RVU-based estimate, not a published national rate.
What does commercial insurance pay for psychotherapy CPT codes?
Commercial payers often reimburse 110-150% of the Medicare rate for psychotherapy codes, though contracts range from below 80% to above 200%. The ranges below apply that band to the 2026 Medicare national rates. Two caveats worth knowing: Medicare pays master's-level clinicians (LCSW, LMFT, LPC) about 75% of the listed physician rate, and plenty of in-network commercial contracts land at or below Medicare. Pull your own contracted rates (BCBS, Aetna, Cigna, UnitedHealthcare, or self-pay) and enter them in the calculator above for a real estimate.
| CPT code | Service | Typical commercial range |
|---|---|---|
| 90791 | Diagnostic intake | $191 - $260 |
| 90832 | 30-min session | $94 - $129 |
| 90834 | 45-min session | $125 - $171 |
| 90837 | 60-min session | $184 - $251 |
| 90846 | Family (no client) | $116 - $159 |
| 90847 | Family (with client) | $121 - $164 |
| 90853 | Group session | $33 - $46 |
Modeled from 2026 Medicare rates, not actual payer fee schedules. Your real rates depend on payer, plan, state, and credential level.
Frequently asked questions
How much does insurance reimburse for CPT code 90834?
Medicare's national non-facility rate for 90834 (45-minute individual psychotherapy) is around $114 in 2026, up from about $102 in 2025 after CMS revalued the psychotherapy work RVUs. Commercial insurance typically pays between 80% and 200% of the Medicare rate depending on the payer and your contract - most therapists see somewhere in the 110-150% range.
What is the difference between 90834 and 90837 reimbursement?
90837 (60-minute psychotherapy) reimburses roughly 45% more than 90834 (45-minute) under Medicare - about $167 vs. $114 nationally in 2026. Some commercial payers flag frequent 90837 billing, so many therapists bill a mix of both.
How accurate is this calculator?
It uses CMS Medicare Physician Fee Schedule national non-facility rates as a baseline, with your own assumptions for commercial contracts and self-pay rates. Actual reimbursement varies by state, locality (GPCI), payer contract, and modifiers - treat the output as a planning estimate, not a guarantee.
What payer mix should I assume for a private practice?
It varies widely. Insurance-panel-heavy practices often run 70-90% commercial, while cash-pay practices in major metros may be majority self-pay. If you're modeling a new practice, a 60% commercial / 20% Medicare / 20% self-pay split is a reasonable starting point to stress-test.
This calculator provides estimates for planning purposes only and does not constitute billing, legal, or financial advice. Reimbursement depends on your payer contracts, state, locality, credentials, and modifiers. Planning your whole practice? Pair this with our private practice income calculator to project take-home pay, and see how HIPAAtherapy keeps sessions, notes, and billing codes in one place.