CPT 90853 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 |
| Common Modifiers | • None • 95 - Telemedicine - audio and video • GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Moderate |
National average reimbursement for CPT 90853 by major payers:
$34.35
$38.70
$43.66
$39.97
| 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 90853 | ||||||
United | 90853 | $22.62 | 1013538636 - OYOYO SAWYER | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $54.29 | 1174859284 - MATTHEW NIEDZWIECKI | 910844563 | CA | Psychiatry Physician (2084P0800X) |
United | 90853 | $81.25 | 1669590741 - STEPHEN DINWIDDIE | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $81.25 | 1528473170 - SANJAYA DHARMAPURI | 460775763 | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $81.25 | 1851540165 - RAJA GILL | 264450645 - (IL) DR RAJA GILL SC | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $81.25 | 1245348952 - CHRISTINE OLSON | 363903368 - (IL) OLSON PSYCARE PC | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $81.25 | 1104020866 - JAMIE PACIS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $51.88 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $42.68 | 1508914029 - ANDREA URIBE | 205220961 - EDGEWOOD CLINICAL SERVICES | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $62.50 | 1033640198 - ABDULLAH BIN MAHFODH | 273861287 - (IL) SUBURBAN BEHAVIORAL HEALTH SERVICES INC. | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $40.00 | 1548279870 - VINOD ALLURI | 274509167 | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $40.00 | 1083603872 - HETAL AMIN | 843229208 - (IL) GATEWAY PROFESSIONAL SERVICES PC | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $46.97 | 1851558001 - LUBOV ROMANTSEVA | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90853 | $40.00 | 1477572733 - FEITENG SU | 141880824 - (IL) PROMISE HEALTHCARE NFP | IL | Psychiatry Physician (2084P0800X) |
United | 90853 | $52.79 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 90853 vs. Other Psychiatry Services and Procedures Codes
The CPT 90853 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 90853 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 |
|---|---|---|
| 90832 | Low | Psychotherapy, 30 Minutes With Patient; Medicaid Level Of Care 7, As Defined By Each State |
| 90834 | Low | Psychotherapy, 45 Minutes With The Pt And/Or Famil Y Member. Pt Must Be Pressent For All Or Some Of The Service. Focus Of The Session Is Still On The Pt And Not On The Family Unit. |
| 90837 | Low | Psychotherapy 60 Minutes Member Of High Risk Population-Use W Immunizations Via Interactive Audio And Video Telecommunication |
| 90853 | Low | Group Medical Psychotherapy(Other Than Of A Mltpl-Family Grp) By A Physician, With Continuing Medi- Cal Diagnostic Eval And Drug Mngmnt Whe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90853. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90853 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 90853) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.