CPT code 90833: Psychotherapy with E/M, add-on, 30 minutes2026 Medicare rate & RVUs in Alabama
Add-on for about 30 minutes of individual psychotherapy delivered in the same encounter as a separately documented E/M service, typically during psychiatric medication management visits.
In Alabama, Medicare pays $77.73 for 90833 in the office and $63.99 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90833 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 90833 covers
This add-on captures individual psychotherapy that a prescribing clinician provides during the same visit as an evaluation and management service. The typical scenario is a psychiatrist, psychiatric nurse practitioner, or physician assistant who reviews symptoms, side effects, and medications, then spends dedicated time on supportive, cognitive behavioral, or other therapeutic techniques with the patient. It is reported in offices, outpatient clinics, hospitals, nursing facilities, and telehealth settings. Clinicians who cannot bill E/M services, such as psychologists and clinical social workers, use the standalone psychotherapy codes instead.
This level requires 16 to 37 minutes of psychotherapy. Psychotherapy time must be documented separately from E/M time and excluded from any E/M time used to select its level; the E/M may instead be selected by medical decision making. The note should show the therapeutic approach, the patient's response, and the start and stop time or total psychotherapy minutes. As an add-on, 90833 is reported with a primary E/M service and paid within that service's global period.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Billing guides for 90833: Psychotherapy add-on codes · Psychotherapy CPT codes · Mental health billing
How Alabama compares for 90833
Across 109 of 109 payment localities, the office rate for 90833 runs from $77.26 in Arkansas to $110.44 in Alaska. Alabama pays $77.73. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$77.73
- Los Angeles, CA · California$87.09+$9.36
- Washington, DC area · District of Columbia$88.77+$11.04
- Miami, FL · Florida$85.98+$8.25
- Chicago, IL · Illinois$85.04+$7.31
- Manhattan, NY · New York$90.09+$12.36
- Alaska · Alaska$110.44+$32.71
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $77.26 | $63.77 |
| ArizonaArizona | $80.48 | $65.27 |
| Bakersfield, CACalifornia | $83.79 | $66.58 |
| Chico, CACalifornia | $83.50 | $66.30 |
| El Centro, CACalifornia | $83.51 | $66.31 |
| Fresno, CACalifornia | $83.50 | $66.30 |
| Hanford, CACalifornia | $83.50 | $66.30 |
| Madera, CACalifornia | $83.50 | $66.30 |
| Merced, CACalifornia | $83.50 | $66.30 |
| Modesto, CACalifornia | $83.50 | $66.30 |
| Napa, CACalifornia | $90.96 | $70.27 |
| Oxnard, CACalifornia | $86.23 | $67.67 |
| Redding, CACalifornia | $83.50 | $66.30 |
| Rest of CaliforniaCalifornia | $83.50 | $66.30 |
| Riverside, CACalifornia | $84.30 | $67.09 |
| Sacramento, CACalifornia | $86.06 | $67.81 |
| Salinas, CACalifornia | $85.69 | $67.49 |
| San Diego, CACalifornia | $86.46 | $67.69 |
| Marin County, CACalifornia | $94.70 | $72.56 |
| San Francisco, CACalifornia | $94.62 | $72.48 |
| San Benito County, CACalifornia | $96.44 | $73.80 |
| Santa Clara County, CACalifornia | $96.11 | $73.48 |
| San Luis Obispo, CACalifornia | $84.45 | $66.57 |
| Santa Cruz, CACalifornia | $86.35 | $67.28 |
| Santa Maria, CACalifornia | $85.67 | $67.37 |
| Santa Rosa, CACalifornia | $87.15 | $67.88 |
| Stockton, CACalifornia | $83.50 | $66.30 |
| Vallejo, CACalifornia | $90.84 | $70.15 |
| Visalia, CACalifornia | $83.50 | $66.30 |
| Yuba City, CACalifornia | $83.50 | $66.30 |
| ColoradoColorado | $83.08 | $66.38 |
| ConnecticutConnecticut | $84.83 | $67.92 |
| DelawareDelaware | $81.28 | $65.77 |
| Fort Lauderdale, FLFlorida | $83.67 | $67.77 |
| Rest of FloridaFlorida | $81.70 | $66.70 |
| Atlanta, GAGeorgia | $82.49 | $66.54 |
| Rest of GeorgiaGeorgia | $79.57 | $65.56 |
| Hawaii, Guam, HIHawaii | $83.53 | $65.68 |
| IowaIowa | $78.21 | $63.85 |
| IdahoIdaho | $78.50 | $64.06 |
| East St. Louis, ILIllinois | $82.11 | $67.66 |
| Rest of IllinoisIllinois | $80.90 | $66.56 |
| Suburban Chicago, ILIllinois | $84.30 | $68.18 |
| IndianaIndiana | $78.69 | $64.13 |
| KansasKansas | $78.22 | $64.03 |
| KentuckyKentucky | $78.85 | $64.90 |
| New Orleans, LALouisiana | $80.52 | $65.74 |
| Rest of LouisianaLouisiana | $78.86 | $64.97 |
| Metropolitan Boston, MAMassachusetts | $87.86 | $69.12 |
| Rest of MassachusettsMassachusetts | $83.11 | $66.58 |
| Baltimore area, MDMaryland | $84.58 | $67.73 |
| Rest of MarylandMaryland | $82.14 | $66.26 |
| Rest of MaineMaine | $78.85 | $64.41 |
| Southern Maine, MEMaine | $80.44 | $64.88 |
| Detroit, MIMichigan | $82.33 | $67.18 |
| Rest of MichiganMichigan | $79.88 | $65.55 |
| MinnesotaMinnesota | $80.49 | $64.34 |
| Metropolitan Kansas City, MOMissouri | $80.10 | $65.36 |
| Metropolitan St. Louis, MOMissouri | $80.44 | $65.50 |
| Rest of MissouriMissouri | $78.40 | $64.86 |
| MississippiMississippi | $77.82 | $64.31 |
| MontanaMontana | $81.49 | $65.80 |
| North CarolinaNorth Carolina | $79.18 | $64.53 |
| North DakotaNorth Dakota | $80.11 | $64.41 |
| NebraskaNebraska | $78.35 | $63.86 |
| New HampshireNew Hampshire | $82.11 | $65.77 |
| Northern New JerseyNew Jersey | $88.78 | $70.57 |
| Rest of New JerseyNew Jersey | $86.04 | $68.90 |
| New MexicoNew Mexico | $80.14 | $65.74 |
| NevadaNevada | $81.13 | $65.42 |
| NYC suburbs and Long Island, NYNew York | $91.32 | $72.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $86.65 | $69.46 |
| Queens, NYNew York | $90.20 | $71.64 |
| Rest of New YorkNew York | $79.70 | $64.79 |
| OhioOhio | $79.60 | $65.27 |
| OklahomaOklahoma | $78.62 | $64.60 |
| Portland, OROregon | $84.26 | $66.82 |
| Rest of OregonOregon | $80.72 | $65.08 |
| Metropolitan Philadelphia, PAPennsylvania | $83.88 | $67.54 |
| Rest of PennsylvaniaPennsylvania | $79.56 | $65.15 |
| Puerto RicoPuerto Rico | $81.71 | $65.83 |
| Rhode IslandRhode Island | $83.06 | $66.84 |
| South CarolinaSouth Carolina | $79.47 | $64.97 |
| South DakotaSouth Dakota | $79.95 | $64.25 |
| TennesseeTennessee | $78.41 | $64.14 |
| Austin, TXTexas | $82.62 | $66.02 |
| Beaumont, TXTexas | $79.35 | $65.06 |
| Brazoria, TXTexas | $81.24 | $65.69 |
| Dallas, TXTexas | $81.59 | $65.96 |
| Fort Worth, TXTexas | $81.40 | $65.92 |
| Galveston, TXTexas | $81.40 | $65.81 |
| Houston, TXTexas | $82.68 | $67.09 |
| Rest of TexasTexas | $80.15 | $65.25 |
| UtahUtah | $79.94 | $65.18 |
| VirginiaVirginia | $80.44 | $65.00 |
| Virgin Islands, VIUnited States Virgin Islands | $81.71 | $65.83 |
| VermontVermont | $80.12 | $64.58 |
| Rest of WashingtonWashington | $82.85 | $66.32 |
| King County, WAWashington | $88.93 | $69.67 |
| WisconsinWisconsin | $78.95 | $63.92 |
| West VirginiaWest Virginia | $79.62 | $65.98 |
| WyomingWyoming | $80.89 | $65.19 |
90833 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$77.26
$110.44
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $110.44 | 1 |
| AL | $77.73 | 1 |
| AR | $77.26 | 1 |
| AZ | $80.48 | 1 |
| CA | $83.50–$96.44 | 29 |
| CO | $83.08 | 1 |
| CT | $84.83 | 1 |
| DC | $88.77 | 1 |
| DE | $81.28 | 1 |
| FL | $81.70–$85.98 | 3 |
| GA | $79.57–$82.49 | 2 |
| GU | $83.53 | 1 |
| HI | $83.53 | 1 |
| IA | $78.21 | 1 |
| ID | $78.50 | 1 |
| IL | $80.90–$85.04 | 4 |
| IN | $78.69 | 1 |
| KS | $78.22 | 1 |
| KY | $78.85 | 1 |
| LA | $78.86–$80.52 | 2 |
| MA | $83.11–$87.86 | 2 |
| MD | $82.14–$88.77 | 3 |
| ME | $78.85–$80.44 | 2 |
| MI | $79.88–$82.33 | 2 |
| MN | $80.49 | 1 |
| MO | $78.40–$80.44 | 3 |
| MS | $77.82 | 1 |
| MT | $81.49 | 1 |
| NC | $79.18 | 1 |
| ND | $80.11 | 1 |
| NE | $78.35 | 1 |
| NH | $82.11 | 1 |
| NJ | $86.04–$88.78 | 2 |
| NM | $80.14 | 1 |
| NV | $81.13 | 1 |
| NY | $79.70–$91.32 | 5 |
| OH | $79.60 | 1 |
| OK | $78.62 | 1 |
| OR | $80.72–$84.26 | 2 |
| PA | $79.56–$83.88 | 2 |
| PR | $81.71 | 1 |
| RI | $83.06 | 1 |
| SC | $79.47 | 1 |
| SD | $79.95 | 1 |
| TN | $78.41 | 1 |
| TX | $79.35–$82.68 | 8 |
| UT | $79.94 | 1 |
| VA | $80.44–$88.77 | 2 |
| VI | $81.71 | 1 |
| VT | $80.12 | 1 |
| WA | $82.85–$88.93 | 2 |
| WI | $78.95 | 1 |
| WV | $79.62 | 1 |
| WY | $80.89 | 1 |
How the 90833 rate is calculated
Each of 90833’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 90833
RVUs × geographic indexes × conversion factor
Work1.71
1.71 RVUs× 1.000 GPCI
Practice expense0.66
0.66 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.4400
Conversion factor
$33.4009
Medicare rate
$81.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,530
- Code
- 90833
- Physician work
- 1.71
- Practice expense
- 0.66
- Malpractice
- 0.07
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.000 | 1.7100 |
| Practice expense | 0.66 | × 0.875 | 0.5775 |
| Malpractice | 0.07 | × 0.566 | 0.0396 |
| Total RVUs | 2.3271 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$77.73
Office: (1.71 × 1 + 0.66 × 0.875 + 0.07 × 0.566) × $33.4009 = $77.73
Facility: (1.71 × 1 + 0.19 × 0.875 + 0.07 × 0.566) × $33.4009 = $63.99
Payment rules and modifiers for 90833
The CMS indicators that decide how 90833 is paid alongside other services.
CMS payment indicators · 90833
Psychotherapy with E/M, add-on, 30 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 90833 has changed in Alabama
90833 · Office / nonfacility
$77.73
Effective 2026-10-01
The base rate is $8.11 higher than on 2025-10-01, moving from $69.62 to $77.73 (11.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$69.62changed to$77.73
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.64 changed to 1.71
- Practice expense RVU 0.55 changed to 0.66
- Malpractice RVU 0.06 changed to 0.07
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$68.64changed to$69.62
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 1.57 changed to 1.64
- Practice expense RVU 0.52 changed to 0.55
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$67.52changed to$68.64
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$66.93changed to$67.52
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 1.50 changed to 1.57
- Practice expense RVU 0.49 changed to 0.52
- Malpractice RVU 0.06 changed to 0.07
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$69.20changed to$66.93
- Conversion factor 34.6062 changed to 33.8872
- Malpractice RVU 0.07 changed to 0.06
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$69.13changed to$69.20
- Conversion factor 34.8931 changed to 34.6062
- Malpractice RVU 0.05 changed to 0.07
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$70.42changed to$69.13
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.46 changed to 0.49
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$68.13changed to$70.42
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.40 changed to 0.46
- Malpractice RVU 0.07 changed to 0.06
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$66.45changed to$68.13
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.35 changed to 0.40
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$66.45
Held through RVU18C, RVU18D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $77.73 | $63.99 | RVU26D |
| 2026-07-01 | $77.73 | $63.99 | RVU26C |
| 2026-04-01 | $77.73 | $63.99 | RVU26B |
| 2026-01-01 | $77.73 | $63.99 | RVU26A |
| 2025-10-01 | $69.62 | $62.32 | RVU25D |
| 2025-07-01 | $69.62 | $62.32 | RVU25C |
| 2025-04-01 | $69.62 | $62.32 | RVU25B |
| 2025-01-01 | $69.62 | $62.32 | RVU25A |
| 2024-10-01 | $68.64 | $61.70 | RVU24D |
| 2024-07-01 | $68.64 | $61.70 | RVU24C |
| 2024-04-01 | $68.64 | $61.70 | RVU24B |
| 2024-03-09 | $68.64 | $61.70 | RVU24AR |
| 2024-01-01 | $67.52 | $60.69 | RVU24A |
| 2023-10-01 | $66.93 | $60.38 | RVU23D |
| 2023-07-01 | $66.93 | $60.38 | RVU23C |
| 2023-04-01 | $66.93 | $60.38 | RVU23B |
| 2023-01-01 | $66.93 | $60.38 | RVU23A |
| 2022-10-01 | $69.20 | $62.44 | RVU22D |
| 2022-07-01 | $69.20 | $62.44 | RVU22C |
| 2022-04-01 | $69.20 | $62.44 | RVU22B |
| 2022-01-01 | $69.20 | $62.44 | RVU22A |
| 2021-10-01 | $69.13 | $62.31 | RVU21D |
| 2021-07-01 | $69.13 | $62.31 | RVU21C |
| 2021-04-01 | $69.13 | $62.31 | RVU21B |
| 2021-01-01 | $69.13 | $62.31 | RVU21A |
| 2020-10-01 | $70.42 | $64.65 | RVU20D |
| 2020-07-01 | $70.42 | $64.65 | RVU20C |
| 2020-04-01 | $70.42 | $64.65 | RVU20B |
| 2020-01-01 | $70.42 | $64.65 | RVU20A |
| 2019-10-01 | $68.13 | $63.96 | RVU19D |
| 2019-07-01 | $68.13 | $63.96 | RVU19C |
| 2019-04-01 | $68.13 | $63.96 | RVU19B |
| 2019-01-01 | $68.13 | $63.96 | RVU19A |
| 2018-10-01 | $66.45 | $64.21 | RVU18D |
| 2018-07-01 | $66.45 | $64.21 | RVU18C |
| 2018-04-01 | $66.45 | $64.21 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
90833 billing questions
How do I choose between 90833, 90836, and 90838?
Select by psychotherapy minutes only, excluding E/M time: 16 to 37 minutes reports 90833, 38 to 52 minutes reports 90836, and 53 minutes or more reports 90838. Under 16 minutes, psychotherapy is not separately reported.
Can E/M time and psychotherapy time be combined to pick the E/M level?
No. Psychotherapy minutes cannot count toward an E/M level selected by time. Select the E/M by medical decision making or qualifying E/M time, and document the two services separately.
Can a psychologist or LCSW bill 90833?
No. The code requires a companion E/M service, which these clinicians cannot report. They bill 90832, 90834, or 90837 for individual psychotherapy.
Which primary codes can 90833 be reported with?
It pairs with E/M services such as office and outpatient visits (99202-99205, 99212-99215), hospital inpatient and observation visits, and nursing facility visits. It is not paired with crisis psychotherapy codes 90839 or 90840.
Can interactive complexity be added?
Yes. When factors such as a caregiver's disruptive communication complicate the psychotherapy, 90785 may be reported with 90833. The E/M service alone does not support adding 90785.
Does 90833 need a modifier like 25 on the E/M?
The E/M does not require modifier 25 solely because it is reported with 90833. Document the distinct E/M work and psychotherapy time.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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