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

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 North Carolina, Medicare pays $79.18 for 90833 in the office and $64.53 when it’s performed in a hospital or facility.

$79.18Office (non-facility)
$64.53Hospital or facility
−2.8%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 North Carolina
  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 North Carolina 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. North Carolina pays $79.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

90833 in North Carolina vs other payment areas
  1. North Carolina · this page$79.18
  2. Los Angeles, CA · California$87.09+$7.91
  3. Washington, DC area · District of Columbia$88.77+$9.59
  4. Miami, FL · Florida$85.98+$6.80
  5. Chicago, IL · Illinois$85.04+$5.86
  6. Manhattan, NY · New York$90.09+$10.91
  7. Alaska · Alaska$110.44+$31.26

Other areas in North Carolina 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.

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 90833 in North Carolina
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0001.7100
Practice expense0.66× 0.9330.6158
Malpractice0.07× 0.6390.0447
Total RVUs2.3705
Conversion factor× 33.4009

Office rate, North Carolina$79.18

Office: (1.71 × 1 + 0.66 × 0.933 + 0.07 × 0.639) × $33.4009 = $79.18

Facility: (1.71 × 1 + 0.19 × 0.933 + 0.07 × 0.639) × $33.4009 = $64.53

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 North Carolina

90833 · Office / nonfacility

$79.18

Effective 2026-10-01

The base rate is $8.37 higher than on 2025-10-01, moving from $70.81 to $79.18 (11.8%).

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

    $70.81changed to$79.18

    • 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 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $69.84changed to$70.81

    • 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

    $68.70changed to$69.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $67.73changed to$68.70

    • 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 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $69.63changed to$67.73

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $69.64changed to$69.63

    • 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

    $71.21changed to$69.64

    • 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 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $69.23changed to$71.21

    • 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 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $67.48changed to$69.23

    • 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

    $65.36changed to$67.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.29 changed to 0.35
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $65.01changed to$65.36

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $64.97changed to$65.01

    • 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

    $64.65changed to$64.97

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $64.96changed to$64.65

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $40.60changed to$64.96

    • 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
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $40.60

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$79.18$64.53RVU26D
2026-07-01$79.18$64.53RVU26C
2026-04-01$79.18$64.53RVU26B
2026-01-01$79.18$64.53RVU26A
2025-10-01$70.81$63.03RVU25D
2025-07-01$70.81$63.03RVU25C
2025-04-01$70.81$63.03RVU25B
2025-01-01$70.81$63.03RVU25A
2024-10-01$69.84$62.44RVU24D
2024-07-01$69.84$62.44RVU24C
2024-04-01$69.84$62.44RVU24B
2024-03-09$69.84$62.44RVU24AR
2024-01-01$68.70$61.42RVU24A
2023-10-01$67.73$60.82RVU23D
2023-07-01$67.73$60.82RVU23C
2023-04-01$67.73$60.82RVU23B
2023-01-01$67.73$60.82RVU23A
2022-10-01$69.63$62.56RVU22D
2022-07-01$69.63$62.56RVU22C
2022-04-01$69.63$62.56RVU22B
2022-01-01$69.63$62.56RVU22A
2021-10-01$69.64$62.51RVU21D
2021-07-01$69.64$62.51RVU21C
2021-04-01$69.64$62.51RVU21B
2021-01-01$69.64$62.51RVU21A
2020-10-01$71.21$65.17RVU20D
2020-07-01$71.21$65.17RVU20C
2020-04-01$71.21$65.17RVU20B
2020-01-01$71.21$65.17RVU20A
2019-10-01$69.23$64.87RVU19D
2019-07-01$69.23$64.87RVU19C
2019-04-01$69.23$64.87RVU19B
2019-01-01$69.23$64.87RVU19A
2018-10-01$67.48$65.14RVU18D
2018-07-01$67.48$65.14RVU18C
2018-04-01$67.48$65.14RVU18B
2018-01-01$67.48$65.14RVU18AR1
2017-10-01$65.36$64.69RVU17D
2017-07-01$65.36$64.69RVU17C
2017-04-01$65.36$64.69RVU17B
2017-01-01$65.36$64.69RVU17A
2016-10-01$65.01$64.35RVU16D
2016-07-01$65.01$64.35RVU16C
2016-04-01$65.01$64.35RVU16B
2016-01-01$65.01$64.35RVU16A
2015-10-01$64.97$64.30RVU15D
2015-07-01$64.97$64.30RVU15C
2015-04-01$64.65$63.98RVU15B
2015-01-01$64.65$63.98RVU15A
2014-10-01$64.96$64.63RVU14D
2014-07-01$64.96$64.63RVU14C
2014-04-01$64.96$64.63RVU14B
2014-01-01$64.96$64.63RVU14A
2013-10-01$40.60$40.28RVU13D
2013-07-01$40.60$40.28RVU13C
2013-04-01$40.60$40.28RVU13B
2013-01-01$40.60$40.28RVU13AR

Price 90833 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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