CPT 90837 Mental Health

How Much Does Psychotherapy, 53+ minutes Cost?

Psychotherapy, 53+ minutes (CPT 90837) costs $76 at Medicare rates. Hospital outpatient rate: $181.

Cost Comparison by Payer

How much Psychotherapy, 53+ minutes costs across different settings and payers

Medicare
Facility rate
$76
Hospital Outpatient
OPPS rate
$181
Medicare (Facility)
$76
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$107
Non-facility setting
Hospital Outpatient
$181
OPPS rate

Psychotherapy, 53+ minutes Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA* $106 $160 — $266
AL — ALABAMA $75 $112 — $187
AR — ARKANSAS $74 $112 — $186
AZ — ARIZONA $77 $116 — $194
AZ — Phoenix $78 $117 — $195
CA — BAKERSFIELD $80 $121 — $201
CA — CHICO $80 $120 — $200
CA — EL CENTRO $80 $120 — $200
CA — FRESNO $80 $120 — $200
CA — HANFORD-CORCORAN $80 $120 — $200
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $84 $125 — $209
CA — Los Angeles $84 $126 — $210
CA — MADERA $80 $120 — $200
CA — MERCED $80 $120 — $200
CA — MODESTO $80 $120 — $200
CA — NAPA $87 $131 — $218
CA — OXNARD-THOUSAND OAKS-VENTURA $83 $124 — $207
CA — REDDING $80 $120 — $200
CA — REST OF CALIFORNIA $80 $120 — $200
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $81 $122 — $203
CA — SACRAMENTO-ROSEVILLE-FOLSOM $83 $124 — $206
CA — SALINAS $82 $123 — $205
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $83 $124 — $207
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $91 $136 — $226
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $92 $138 — $230

How to Reduce Your Cost for Psychotherapy, 53+ minutes

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($107) differs from the facility rate ($76). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $74 to $200 depending on location. Commercial rates vary even more.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

1.67
Work RVU
0.60
Practice Expense RVU
0.08
Malpractice RVU

Payment = Total RVU () x CF ($33.40) = N/A

Frequently Asked Questions

How much does Psychotherapy, 53+ minutes cost?

The Medicare facility rate for Psychotherapy, 53+ minutes is $76. In a hospital outpatient setting, the rate is $181. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Psychotherapy, 53+ minutes cost without insurance?

Without insurance, the cost of Psychotherapy, 53+ minutes can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Psychotherapy, 53+ minutes?

Most commercial health insurance plans and Medicare cover Psychotherapy, 53+ minutes when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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