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See a sample rate comparisonCPT 90838 Fee Schedule
Last Verified: September 2026
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.
Psychotherapy 60 Minutes With, Psychotherapy 60 Minutes With Patient Andor Family Member When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure)
| 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 |
| Medicare Fee Schedule | View Medicare rates for 90838 |
| Medicaid Fee Schedule | View Medicaid rates for 90838 |
National average reimbursement for CPT 90838 by major payers:
$123.17
$133.08
$133.12
$191.42
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CPT 90838
5 of 25 sample ratesHigher to lower in this preview
Paulo Lizano
Hadine Joffe
$526.00Published rateKaryn Ellis
Bramblebush Pediatrics, LLP
$324.66Published rateTrevor Forbes
Center For Family Guidance, PC
$122.40Published rateSeeba Anam
University Of Chicago
$100.00Published rateAaron Dubrinsky
New Horizons Of The Treasure Coast Inc
$74.75Published rate
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See a sample payer proposalCPT 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, Psychotherapy 30 Minutes With Patient Andor Family Member When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure) |
| 90836-CPT | Low | Psychotherapy 45 Minutes With, Psychotherapy 45 Minutes With Patient Andor Family Member When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure) |
| 90838-CPT | Low | Psychotherapy 60 Minutes With, Psychotherapy 60 Minutes With Patient Andor Family Member When Performed With An Evaluation And Management Service (List Separately In Addition To The Code For Primary Procedure) |
| 90840-CPT | Low | Crisis Therapy 30 Mins, Psychotherapy Session With Psychiatrist Psychologist Or Other Mental Health Professional For Crisis Management; 30 Minutes. |
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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