CPT 90838 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Psychiatry Services and Procedures |
| Common Place of Service | • 11 - Office • None • 10 - Telehealth in Patient's Home |
| Common Modifiers | • None • 95 - Telemedicine - audio and video • GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
National average reimbursement for CPT 90838 by major payers:
$123.17
$133.08
$133.12
$188.59
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 90838 | ||||||
United | 90838 | $526.00 | 1740522192 - PAULO LIZANO | 1447226956 - (MA) HADINE JOFFE | MA | Psychiatry Physician (2084P0800X) |
United | 90838 | $526.00 | 1023065299 - GEORGE DOMINIAK | 1598269516 - (MA) ASHLEY NIEVES ARCHIBALD | MA | Psychiatry Physician (2084P0800X) |
United | 90838 | $76.75 | 1124016902 - GONCHIGARI NARAYANA | 363678909 - ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH | IL | Psychiatry Physician (2084P0800X) |
United | 90838 | $119.05 | 1427744523 - RACHAEL BABINEAU | 851308076 - (MA) KRIPA BEHAVIORAL HEALTH, PC | MA | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | 90838 | $122.40 | 1700310653 - AYESHA ADIL | 221487148 - CHILDREN'S SPECIALIZED HOSPITAL | NJ | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90838 | $139.11 | 1184120610 - BRIAN MEDLIN | 844576785 - (FL) ONEMED FLORIDA LLC | FL | Psychiatry Physician (2084P0800X) |
United | 90838 | $99.08 | 1447609474 - DANIELA LOSEY | 237086112 - (AZ) CODAC HEALTH RECOVERY AND WELLNESS | AZ | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | 90838 | $324.66 | 1225178346 - KARYN ELLIS | 42705210 - (MA) BRAMBLEBUSH PEDIATRICS, LLP | MA | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | 90838 | $166.78 | 1073648192 - NIRANJAN KARNIK | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90838 | $526.00 | 1598269516 - ASHLEY NIEVES ARCHIBALD | 1811493257 - (NY) MARLEE MADORA | NY | Psychiatry Physician (2084P0800X) |
United | 90838 | $74.75 | 1932237245 - AARON DUBRINSKY | 596153749 - (FL) NEW HORIZONS OF THE TREASURE COAST INC | FL | Psychiatry Physician (2084P0800X) |
United | 90838 | $503.35 | 1871579367 - DAVID RUBIN | 42697983 - MASS GENERAL BRIGHAM INCORPORATED | MA | Psychiatry Physician (2084P0800X) |
United | 90838 | $120.00 | 1457397903 - RAMAKRISHNA RAO | 463519576 | TX | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90838 | $116.56 | 1013014737 - HANY MIKHAIL | 650816927 - (FL) PREMIER BEHAVIORAL SOLUTIONS OF FLORIDA INC | FL | Psychiatry Physician (2084P0800X) |
United | 90838 | $104.04 | 1619559382 - MELISSA BOYD | 463997917 - (MD) PSYCHNP WELLNESS CENTER LLC | GA | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 90838 vs. Other Psychiatry Services and Procedures Codes
The CPT 90838 code is part of the Medicine Services and Procedures services used for Psychiatry Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90838 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90833-CPT | Low | Psychotherapy 30 Minutes With Patient When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure). (Desc Revised 01/01/2017) |
| 90836-CPT | Low | Psychotherapy 45 Minutes With Patient When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure). (Desc Revised 01/01/2017) |
| 90838-CPT | Low | Psychotherapy 60 Minutes With Patient When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure). (Desc Revised 01/01/2017) |
| 90840-CPT | Low | Psychotherapy For Crisis; Each Additional 30 Minutes (List Separately In Addition To Code For Primary Service) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90838. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90838 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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