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CPT code 90833: Psychotherapy with E/M, add-on, 30 minutes2026 Medicare rate & RVUs in Hawaii, Guam, HI

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 Hawaii, Guam, HI, Medicare pays $83.53 for 90833 in the office and $65.68 when it’s performed in a hospital or facility.

$83.53Office (non-facility)
$65.68Hospital or facility
+2.5%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 Hawaii, Guam, HI
  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 Hawaii, Guam, HI 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. Hawaii, Guam, HI pays $83.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

90833 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$83.53
  2. Los Angeles, CA · California$87.09+$3.56
  3. Washington, DC area · District of Columbia$88.77+$5.24
  4. Miami, FL · Florida$85.98+$2.45
  5. Chicago, IL · Illinois$85.04+$1.51
  6. Manhattan, NY · New York$90.09+$6.56
  7. Alaska · Alaska$110.44+$26.91

Other areas in Hawaii first, then benchmark localities. Bars start at $0.

Every other payment area

90833 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$77.73$63.99
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

90833 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
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 Hawaii, Guam, HI 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

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 90833 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0001.7100
Practice expense0.66× 1.1370.7504
Malpractice0.07× 0.5790.0405
Total RVUs2.5010
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$83.53

Office: (1.71 × 1 + 0.66 × 1.137 + 0.07 × 0.579) × $33.4009 = $83.53

Facility: (1.71 × 1 + 0.19 × 1.137 + 0.07 × 0.579) × $33.4009 = $65.68

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.

Codes related to 90833

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 90833
CodeHow it relatesOffice range, Hawaii, Guam, HI
Primary code
99214Office visit, established patient, moderate complexityEstablished office visit selected by moderate medical decision making or at least 30 minutes of E/M time.$142.79
99213Office visit, established patient, low complexityEstablished office visit selected by low medical decision making or at least 20 minutes of E/M time.$100.61
99232Subsequent hospital visit, moderate MDM or 35 minutesSubsequent hospital care visit on an inpatient psychiatric unit can carry this add-on.No office rate
Add-on codes
90785Interactive complexity, communication factorsInteractive complexity add-on may be reported with 90833 when qualifying communication factors complicate therapy.$15.20
Same family
90836Psychotherapy, with E/M, 38–52 minutesNext level: 38 to 52 minutes of psychotherapy with an E/M.$105.93
90838Psychotherapy, with E/M, 60 minutesHighest level: 53 or more minutes of psychotherapy with an E/M.$140.00
Used instead
90832Psychotherapy session, 30 minutes, without E/MStandalone 30-minute psychotherapy when the same clinician does not provide an E/M.$88.54

How 90833 has changed in Hawaii, Guam, HI

90833 · Office / nonfacility

$83.53

Effective 2026-10-01

The base rate is $8.95 higher than on 2025-10-01, moving from $74.58 to $83.53 (12.0%).

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

    $74.58changed to$83.53

    • 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 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $73.46changed to$74.58

    • 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

    $72.26changed to$73.46

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $71.27changed to$72.26

    • 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 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $73.45changed to$71.27

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.07 changed to 0.06
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $73.58changed to$73.45

    • 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

    $74.85changed to$73.58

    • 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 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $72.18changed to$74.85

    • 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 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $70.04changed to$72.18

    • 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

    $67.50changed to$70.04

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.29 changed to 0.35
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $67.26changed to$67.50

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.06 changed to 0.07
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $67.28changed to$67.26

    • 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

    $66.95changed to$67.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $67.29changed to$66.95

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $42.15changed to$67.29

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$42.15

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$83.53$65.68RVU26D
2026-07-01$83.53$65.68RVU26C
2026-04-01$83.53$65.68RVU26B
2026-01-01$83.53$65.68RVU26A
2025-10-01$74.58$64.92RVU25D
2025-07-01$74.58$64.92RVU25C
2025-04-01$74.58$64.92RVU25B
2025-01-01$74.58$64.92RVU25A
2024-10-01$73.46$64.28RVU24D
2024-07-01$73.46$64.28RVU24C
2024-04-01$73.46$64.28RVU24B
2024-03-09$73.46$64.28RVU24AR
2024-01-01$72.26$63.23RVU24A
2023-10-01$71.27$62.73RVU23D
2023-07-01$71.27$62.73RVU23C
2023-04-01$71.27$62.73RVU23B
2023-01-01$71.27$62.73RVU23A
2022-10-01$73.45$64.74RVU22D
2022-07-01$73.45$64.74RVU22C
2022-04-01$73.45$64.74RVU22B
2022-01-01$73.45$64.74RVU22A
2021-10-01$73.58$64.81RVU21D
2021-07-01$73.58$64.81RVU21C
2021-04-01$73.58$64.81RVU21B
2021-01-01$73.58$64.81RVU21A
2020-10-01$74.85$67.41RVU20D
2020-07-01$74.85$67.41RVU20C
2020-04-01$74.85$67.41RVU20B
2020-01-01$74.85$67.41RVU20A
2019-10-01$72.18$66.81RVU19D
2019-07-01$72.18$66.81RVU19C
2019-04-01$72.18$66.81RVU19B
2019-01-01$72.18$66.81RVU19A
2018-10-01$70.04$67.15RVU18D
2018-07-01$70.04$67.15RVU18C
2018-04-01$70.04$67.15RVU18B
2018-01-01$70.04$67.15RVU18AR1
2017-10-01$67.50$66.67RVU17D
2017-07-01$67.50$66.67RVU17C
2017-04-01$67.50$66.67RVU17B
2017-01-01$67.50$66.67RVU17A
2016-10-01$67.26$66.43RVU16D
2016-07-01$67.26$66.43RVU16C
2016-04-01$67.26$66.43RVU16B
2016-01-01$67.26$66.43RVU16A
2015-10-01$67.28$66.45RVU15D
2015-07-01$67.28$66.45RVU15C
2015-04-01$66.95$66.12RVU15B
2015-01-01$66.95$66.12RVU15A
2014-10-01$67.29$66.87RVU14D
2014-07-01$67.29$66.87RVU14C
2014-04-01$67.29$66.87RVU14B
2014-01-01$67.29$66.87RVU14A
2013-10-01$42.15$41.76RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 90833 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

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 Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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