CPT code 90833: Psychotherapy with E/M, add-on, 30 minutes2026 Medicare rate & RVUs in Texas
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.
Medicare pays $79.35–$82.68 for 90833 in the office in Texas, from Beaumont, TX to Houston, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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
Where 90833 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$79.35 to $82.68
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $82.62 | $66.02 |
| Beaumont, TX | $79.35 | $65.06 |
| Brazoria, TX | $81.24 | $65.69 |
| Dallas, TX | $81.59 | $65.96 |
| Fort Worth, TX | $81.40 | $65.92 |
| Galveston, TX | $81.40 | $65.81 |
| Houston, TX | $82.68 | $67.09 |
| Rest of Texas | $80.15 | $65.25 |
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.
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. |
90833 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 90832Psychotherapy session30 minutes, without E/M
- 90832 is standalone psychotherapy without an E/M by the same clinician and can be billed by therapists and psychologists. 90833 requires an E/M by the same clinician and cannot be billed alone.
- 90836PsychotherapyWith E/M, 38–52 minutes
- Both are psychotherapy add-ons to E/M; 90833 covers 16 to 37 minutes of psychotherapy, while 90836 covers 38 to 52 minutes.
- 90863Medication managementWith psychotherapy
- 90863 is a pharmacologic management add-on for prescribers who cannot report E/M, paired with standalone psychotherapy. For 16 to 37 psychotherapy minutes with a separately performed E/M, report the E/M with 90833 instead.
- 90839Crisis psychotherapyInitial 60 minutes
- 90839 is crisis psychotherapy for urgent situations, at least 30 minutes, and is not combined with 90833 or other psychotherapy codes for the same session.
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
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