CPT code 90836: Psychotherapy, with E/M, 38–52 minutes2026 Medicare rate & RVUs in Missouri
Report 90836 for 38–52 minutes of individual psychotherapy performed with a separately documented evaluation and management service during the same encounter.
Medicare pays $99.27–$101.87 for 90836 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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 90836 covers
Code 90836 describes individual psychotherapy provided to a patient during an encounter that also includes evaluation and management. It is commonly reported by psychiatrists and other qualified clinicians for sessions addressing concerns such as depression, anxiety, trauma, or coping with illness, when the clinician also evaluates or manages the patient’s medical or psychiatric condition. The psychotherapy portion must last 38–52 minutes; time spent on the E/M service is separate from psychotherapy time.
Report 90836 only with an appropriate primary E/M code for the same encounter; it is not a stand-alone psychotherapy code. The note should support the psychotherapy time, focus, interventions, and patient response, as well as the distinct assessment and management work supporting the E/M service. CMS classifies 90836 as an add-on code and pays it within the primary procedure’s global period. Select the psychotherapy level by documented psychotherapy time, not by the total appointment length.
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 90836: Psychotherapy add-on codes · Psychotherapy CPT codes · Mental health billing
Where 90836 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$99.27 to $101.87
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $101.44 | $82.62 |
| Metropolitan St. Louis, MO | $101.87 | $82.79 |
| Rest of Missouri | $99.27 | $81.99 |
How the 90836 rate is calculated
Each of 90836’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 · 90836
RVUs × geographic indexes × conversion factor
Work2.17
2.17 RVUs× 1.000 GPCI
Practice expense0.84
0.84 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
3.0900
Conversion factor
$33.4009
Medicare rate
$103.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90836
The CMS indicators that decide how 90836 is paid alongside other services.
CMS payment indicators · 90836
Psychotherapy, with E/M, 38–52 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. |
90836 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 90834Psychotherapy session45 minutes, without E/M
- Both represent 38–52 minutes of psychotherapy. Choose 90836 when an E/M service is also performed and reported; choose 90834 when psychotherapy is provided without E/M.
- 90833Psychotherapy with E/MAdd-on, 30 minutes
- Both are psychotherapy add-ons used with E/M. 90833 is for a shorter psychotherapy time; 90836 requires 38–52 minutes.
- 90838PsychotherapyWith E/M, 60 minutes
- Both are psychotherapy add-ons used with E/M. 90838 is for a longer psychotherapy time than the 38–52 minutes reported with 90836.
- 90837Psychotherapy60 minutes, no E/M
- 90837 reports longer-duration psychotherapy without an E/M add-on structure. Use 90836 for 38–52 minutes when a separately supported E/M service is also performed.
90836 billing questions
When should I choose 90836 instead of 90834?
Use 90836 when 38–52 minutes of psychotherapy are performed with an E/M service in the same encounter. Use 90834 for that psychotherapy time when it is reported without an E/M service.
Which primary service must accompany 90836?
Report it with an appropriate E/M code for the same encounter, such as a qualifying office or outpatient E/M service. The E/M work must be supported separately from the psychotherapy.
Can 90836 be billed by itself?
No. CMS identifies 90836 as an add-on code that must be billed with a primary procedure.
How should time be documented?
Document 38–52 minutes of psychotherapy and distinguish that time from time spent on E/M work. The total appointment length alone does not establish the psychotherapy level.
Does the E/M service need separate documentation?
Yes. The record should support the assessment and management work as well as the psychotherapy interventions, focus, and patient response.
Should modifier 25 be added to 90836?
90836 is the psychotherapy add-on, not a replacement for the primary E/M code. Modifier 25 does not replace the requirement to report and document the appropriate E/M service.
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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