CPT code 90833: Psychotherapy with E/M, add-on, 30 minutes2026 Medicare rate & RVUs in Washington, DC area

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.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5M Medicare services in 2024

In Washington, DC area, Medicare pays $88.77 for 90833 in the office and $70.28 when it’s performed in a hospital or facility.

$88.77Office (non-facility)
$70.28Hospital or facility
+8.9%vs the national office rate ($81.50)

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.

We’ll open 90833 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 90833 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Washington, DC area 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. Washington, DC area pays $88.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

90833 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$88.77
  2. Los Angeles, CA · California$87.09−$1.68
  3. Miami, FL · Florida$85.98−$2.79
  4. Chicago, IL · Illinois$85.04−$3.73
  5. Manhattan, NY · New York$90.09+$1.32
  6. Alaska · Alaska$110.44+$21.67
  7. Alabama · Alabama$77.73−$11.04

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

90833 in every other Medicare payment locality
Payment localityOfficeFacility
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

90833 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
90833 office rate range by state
State / territoryOffice rate rangeLocalities
AK$110.441
AL$77.731
AR$77.261
AZ$80.481
CA$83.50–$96.4429
CO$83.081
CT$84.831
DC$88.771
DE$81.281
FL$81.70–$85.983
GA$79.57–$82.492
GU$83.531
HI$83.531
IA$78.211
ID$78.501
IL$80.90–$85.044
IN$78.691
KS$78.221
KY$78.851
LA$78.86–$80.522
MA$83.11–$87.862
MD$82.14–$88.773
ME$78.85–$80.442
MI$79.88–$82.332
MN$80.491
MO$78.40–$80.443
MS$77.821
MT$81.491
NC$79.181
ND$80.111
NE$78.351
NH$82.111
NJ$86.04–$88.782
NM$80.141
NV$81.131
NY$79.70–$91.325
OH$79.601
OK$78.621
OR$80.72–$84.262
PA$79.56–$83.882
PR$81.711
RI$83.061
SC$79.471
SD$79.951
TN$78.411
TX$79.35–$82.688
UT$79.941
VA$80.44–$88.772
VI$81.711
VT$80.121
WA$82.85–$88.932
WI$78.951
WV$79.621
WY$80.891

See 90833 in every payment locality

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

Office or facility?

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 90833 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0541.8023
Practice expense0.66× 1.1780.7775
Malpractice0.07× 1.1130.0779
Total RVUs2.6577
Conversion factor× 33.4009

Office rate, Washington, DC area$88.77

Office: (1.71 × 1.054 + 0.66 × 1.178 + 0.07 × 1.113) × $33.4009 = $88.77

Facility: (1.71 × 1.054 + 0.19 × 1.178 + 0.07 × 1.113) × $33.4009 = $70.28

Open 90833 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 90833 has changed in Washington, DC area

90833 · Office / nonfacility

$88.77

Effective 2026-10-01

The base rate is $9.22 higher than on 2025-10-01, moving from $79.55 to $88.77 (11.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $79.55changed to$88.77

    • 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
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $78.59changed to$79.55

    • 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.

  3. March 9, 2024

    RVU24AR

    $77.31changed to$78.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $76.34changed to$77.31

    • 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
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $78.81changed to$76.34

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.07 changed to 0.06
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $78.56changed to$78.81

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.05 changed to 0.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $79.82changed to$78.56

    • 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
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $77.04changed to$79.82

    • 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
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $74.79changed to$77.04

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.35 changed to 0.40

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $72.15changed to$74.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.29 changed to 0.35
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $71.71changed to$72.15

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.06 changed to 0.07
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $71.51changed to$71.71

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.05 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $71.15changed to$71.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $71.50changed to$71.15

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $44.67changed to$71.50

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 0.98 changed to 1.50
    • Practice expense RVU 0.20 changed to 0.29
    • Malpractice RVU 0.04 changed to 0.06
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $44.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$88.77$70.28RVU26D
2026-07-01$88.77$70.28RVU26C
2026-04-01$88.77$70.28RVU26B
2026-01-01$88.77$70.28RVU26A
2025-10-01$79.55$69.52RVU25D
2025-07-01$79.55$69.52RVU25C
2025-04-01$79.55$69.52RVU25B
2025-01-01$79.55$69.52RVU25A
2024-10-01$78.59$69.07RVU24D
2024-07-01$78.59$69.07RVU24C
2024-04-01$78.59$69.07RVU24B
2024-03-09$78.59$69.07RVU24AR
2024-01-01$77.31$67.94RVU24A
2023-10-01$76.34$67.29RVU23D
2023-07-01$76.34$67.29RVU23C
2023-04-01$76.34$67.29RVU23B
2023-01-01$76.34$67.29RVU23A
2022-10-01$78.81$69.40RVU22D
2022-07-01$78.81$69.40RVU22C
2022-04-01$78.81$69.40RVU22B
2022-01-01$78.81$69.40RVU22A
2021-10-01$78.56$69.07RVU21D
2021-07-01$78.56$69.07RVU21C
2021-04-01$78.56$69.07RVU21B
2021-01-01$78.56$69.07RVU21A
2020-10-01$79.82$71.89RVU20D
2020-07-01$79.82$71.89RVU20C
2020-04-01$79.82$71.89RVU20B
2020-01-01$79.82$71.89RVU20A
2019-10-01$77.04$71.40RVU19D
2019-07-01$77.04$71.40RVU19C
2019-04-01$77.04$71.40RVU19B
2019-01-01$77.04$71.40RVU19A
2018-10-01$74.79$71.75RVU18D
2018-07-01$74.79$71.75RVU18C
2018-04-01$74.79$71.75RVU18B
2018-01-01$74.79$71.75RVU18AR1
2017-10-01$72.15$71.29RVU17D
2017-07-01$72.15$71.29RVU17C
2017-04-01$72.15$71.29RVU17B
2017-01-01$72.15$71.29RVU17A
2016-10-01$71.71$70.84RVU16D
2016-07-01$71.71$70.84RVU16C
2016-04-01$71.71$70.84RVU16B
2016-01-01$71.71$70.84RVU16A
2015-10-01$71.51$70.64RVU15D
2015-07-01$71.51$70.64RVU15C
2015-04-01$71.15$70.29RVU15B
2015-01-01$71.15$70.29RVU15A
2014-10-01$71.50$71.07RVU14D
2014-07-01$71.50$71.07RVU14C
2014-04-01$71.50$71.07RVU14B
2014-01-01$71.50$71.07RVU14A
2013-10-01$44.67$44.26RVU13D
2013-07-01$44.67$44.26RVU13C
2013-04-01$44.67$44.26RVU13B
2013-01-01$44.67$44.26RVU13AR

Price 90833 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 90833PPRRVU2026_Oct_nonQPP.csv, line 11,530 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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