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See a sample rate comparisonCPT 90867 Fee Schedule
Last Verified: October 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.
Brain Stimulation Planning, Treatment Planning For Tms (Transcranial Magnetic Stimulation) A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Psychiatry Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service U6 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 90867 |
| Medicaid Fee Schedule | $192.59 median of the 8 states in the free preview · View Medicaid rates for 90867 |
National average reimbursement for CPT 90867 by major payers:
$327.55
$360.05
$271.83
$547.22
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CPT 90867
5 of 25 sample ratesHigher to lower in this preview
David Tran
$1,259.43Published rateBo Hu
$1,116.38Published rateAnita Chu
Foresight Mental Health Inc
$336.60Published rateChristopher Burky
Bayhealth Medical Center Inc
$277.54Published rateAtef Shaikh
Comprehensive Psychiatric Services
$257.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90867 vs. Other Psychiatry Services and Procedures Codes
The CPT 90867 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 90867 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 |
|---|---|---|
| 90865-CPT | Low | Psychiatric Interview, A Psychiatrist Interviews A Person After They Have Been Given Sodium Amobarbital (Amytal) To Induce A Hypnotic State. The Drug Helps To Access Repressed Memories. Drug Effects Are Monitored Overnight. |
| 90867-CPT | Moderate | Brain Stimulation Planning, Treatment Planning For Tms (Transcranial Magnetic Stimulation) A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety. |
| 90868-CPT | Moderate | Brain Activity Stimulation, Tms (Transcranial Magnetic Stimulation) Treatment A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety. |
| 90869-CPT | Moderate | Tcran Magn Stim Redetemine, Transcranial Magnetic Stimulation Treatment (Stimulates Nerve Cells In Brain To Improve Symptoms Of Depression) Subsequent Motor Threshold Re-Determination With Delivery And Management |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90867 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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Frequently Asked Questions
CPT (Current Procedural Terminology) codes are a standardized set of five-digit numeric and alphanumeric codes used by medical professionals to describe medical, surgical, and diagnostic services. They are crucial for billing, insurance claims, and tracking healthcare services.
Finding the exact cost of a medical procedure can be complex due to varying factors like location, provider, insurance plan, and facility. A good starting point is to talk to your healthcare provider or insurance company. For a more direct way to look up prices based on your specific situation, you can use specialized tools.
To look up specific medical procedure prices based on CPT codes and your location, you should use a dedicated fee schedule lookup tool. For this purpose, Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to get an estimate of costs. This can provide more granular and relevant pricing information for your specific situation.
The cost of medical procedures is influenced by several factors, including the specific CPT code for the service, the geographic location (urban vs. rural), the type of facility (hospital, outpatient clinic, doctor's office), the physician's fees, your insurance coverage (deductibles, co-pays, co-insurance), and whether the provider is in-network or out-of-network.
Yes, there are tools designed to help compare prices for medical services. For comparing prices based on CPT codes and specific locations, you can utilize platforms like Payerprice. Their fee schedule lookup tool allows you to input the CPT code and your location to find potential costs, helping you make more informed decisions about your healthcare spending.