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See a sample rate comparisonHealthcare 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 | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | HE GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $182.04 national non-facility rate (2026) · View Medicare rates for 90870 |
| Medicaid Fee Schedule | $148.165 median of the 8 states in the free preview · View Medicaid rates for 90870 |
National average reimbursement for CPT 90870 by major payers:

$202.76

$205.28

$190.08

$169.90
Choose a payer to see a sample of rates for CPT 90870.
Trixie Lipke
Mchs Hospitals Inc
Sonam Verma
Siu Physicians & Surgeons Inc
Morris Blount
Grand Prairie Services
Kevin Hu
Eric Zimmerman
The Board Of Trustees Of The University Of Illinois
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Rate Benchmarking
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See a sample payer proposalCPT 90870 vs. Other Psychiatry Services and Procedures Codes
The CPT 90870 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 90870 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. |
| 90870-CPT | Moderate | Shock Therapy For Depression, Electroconvulsive Therapy (Ect) Is A Treatment Usually Offered For Severe Depression When Other Treatments Have Failed. Ect Passes Electrical Current Into The Brain Causing A Person To Have A Seizure. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90870 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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