CPT code 90836: Psychotherapy, with E/M, 38–52 minutes2026 Medicare rate & RVUs in South Dakota
Report 90836 for 38–52 minutes of individual psychotherapy performed with a separately documented evaluation and management service during the same encounter.
In South Dakota, Medicare pays $101.43 for 90836 in the office and $81.39 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 90836 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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
How South Dakota compares for 90836
Across 109 of 109 payment localities, the office rate for 90836 runs from $97.96 in Arkansas to $140.07 in Alaska. South Dakota pays $101.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$101.43
- Los Angeles, CA · California$110.42+$8.99
- Washington, DC area · District of Columbia$112.42+$10.99
- Miami, FL · Florida$108.44+$7.01
- Chicago, IL · Illinois$107.32+$5.89
- Manhattan, NY · New York$113.96+$12.53
- Alaska · Alaska$140.07+$38.64
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $98.54 | $81.01 |
| ArkansasArkansas | $97.96 | $80.74 |
| ArizonaArizona | $101.95 | $82.53 |
| Bakersfield, CACalifornia | $106.23 | $84.27 |
| Chico, CACalifornia | $105.89 | $83.93 |
| El Centro, CACalifornia | $105.91 | $83.94 |
| Fresno, CACalifornia | $105.89 | $83.93 |
| Hanford, CACalifornia | $105.89 | $83.93 |
| Madera, CACalifornia | $105.89 | $83.93 |
| Merced, CACalifornia | $105.89 | $83.93 |
| Modesto, CACalifornia | $105.89 | $83.93 |
| Napa, CACalifornia | $115.38 | $88.97 |
| Oxnard, CACalifornia | $109.34 | $85.65 |
| Redding, CACalifornia | $105.89 | $83.93 |
| Rest of CaliforniaCalifornia | $105.89 | $83.93 |
| Riverside, CACalifornia | $106.81 | $84.85 |
| Sacramento, CACalifornia | $109.15 | $85.84 |
| Salinas, CACalifornia | $108.68 | $85.45 |
| San Diego, CACalifornia | $109.66 | $85.69 |
| Marin County, CACalifornia | $120.15 | $91.89 |
| San Francisco, CACalifornia | $120.06 | $91.80 |
| San Benito County, CACalifornia | $122.34 | $93.44 |
| Santa Clara County, CACalifornia | $121.97 | $93.07 |
| San Luis Obispo, CACalifornia | $107.10 | $84.27 |
| Santa Cruz, CACalifornia | $109.52 | $85.17 |
| Santa Maria, CACalifornia | $108.66 | $85.29 |
| Santa Rosa, CACalifornia | $110.54 | $85.93 |
| Stockton, CACalifornia | $105.89 | $83.93 |
| Vallejo, CACalifornia | $115.25 | $88.84 |
| Visalia, CACalifornia | $105.89 | $83.93 |
| Yuba City, CACalifornia | $105.89 | $83.93 |
| ColoradoColorado | $105.29 | $83.97 |
| ConnecticutConnecticut | $107.38 | $85.80 |
| DelawareDelaware | $102.96 | $83.16 |
| Fort Lauderdale, FLFlorida | $105.73 | $85.43 |
| Rest of FloridaFlorida | $103.32 | $84.16 |
| Atlanta, GAGeorgia | $104.41 | $84.05 |
| Rest of GeorgiaGeorgia | $100.69 | $82.82 |
| Hawaii, Guam, HIHawaii | $105.93 | $83.14 |
| IowaIowa | $99.21 | $80.88 |
| IdahoIdaho | $99.56 | $81.12 |
| East St. Louis, ILIllinois | $103.67 | $85.24 |
| Rest of IllinoisIllinois | $102.27 | $83.98 |
| Suburban Chicago, ILIllinois | $106.54 | $85.95 |
| IndianaIndiana | $99.79 | $81.21 |
| KansasKansas | $99.19 | $81.07 |
| KentuckyKentucky | $99.87 | $82.05 |
| New Orleans, LALouisiana | $101.92 | $83.06 |
| Rest of LouisianaLouisiana | $99.87 | $82.13 |
| Metropolitan Boston, MAMassachusetts | $111.33 | $87.40 |
| Rest of MassachusettsMassachusetts | $105.31 | $84.21 |
| Baltimore area, MDMaryland | $107.05 | $85.55 |
| Rest of MarylandMaryland | $104.05 | $83.77 |
| Rest of MaineMaine | $99.95 | $81.52 |
| Southern Maine, MEMaine | $101.97 | $82.11 |
| Detroit, MIMichigan | $104.06 | $84.72 |
| Rest of MichiganMichigan | $101.11 | $82.82 |
| MinnesotaMinnesota | $102.14 | $81.52 |
| Metropolitan Kansas City, MOMissouri | $101.44 | $82.62 |
| Metropolitan St. Louis, MOMissouri | $101.87 | $82.79 |
| Rest of MissouriMissouri | $99.27 | $81.99 |
| MississippiMississippi | $98.61 | $81.36 |
| MontanaMontana | $103.20 | $83.16 |
| North CarolinaNorth Carolina | $100.36 | $81.67 |
| North DakotaNorth Dakota | $101.62 | $81.58 |
| NebraskaNebraska | $99.39 | $80.89 |
| New HampshireNew Hampshire | $104.03 | $83.16 |
| Northern New JerseyNew Jersey | $112.45 | $89.20 |
| Rest of New JerseyNew Jersey | $108.95 | $87.06 |
| New MexicoNew Mexico | $101.42 | $83.04 |
| NevadaNevada | $102.79 | $82.73 |
| NYC suburbs and Long Island, NYNew York | $115.44 | $91.61 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $109.70 | $87.75 |
| Queens, NYNew York | $114.13 | $90.45 |
| Rest of New YorkNew York | $101.01 | $81.97 |
| OhioOhio | $100.79 | $82.49 |
| OklahomaOklahoma | $99.61 | $81.71 |
| Portland, OROregon | $106.80 | $84.53 |
| Rest of OregonOregon | $102.30 | $82.34 |
| Metropolitan Philadelphia, PAPennsylvania | $106.18 | $85.32 |
| Rest of PennsylvaniaPennsylvania | $100.76 | $82.36 |
| Puerto RicoPuerto Rico | $103.48 | $83.22 |
| Rhode IslandRhode Island | $105.22 | $84.52 |
| South CarolinaSouth Carolina | $100.68 | $82.16 |
| TennesseeTennessee | $99.42 | $81.20 |
| Austin, TXTexas | $104.68 | $83.47 |
| Beaumont, TXTexas | $100.49 | $82.26 |
| Brazoria, TXTexas | $102.95 | $83.09 |
| Dallas, TXTexas | $103.37 | $83.41 |
| Fort Worth, TXTexas | $103.12 | $83.36 |
| Galveston, TXTexas | $103.13 | $83.23 |
| Houston, TXTexas | $104.60 | $84.70 |
| Rest of TexasTexas | $101.52 | $82.50 |
| UtahUtah | $101.25 | $82.41 |
| VirginiaVirginia | $101.95 | $82.25 |
| Virgin Islands, VIUnited States Virgin Islands | $103.48 | $83.22 |
| VermontVermont | $101.61 | $81.77 |
| Rest of WashingtonWashington | $105.00 | $83.90 |
| King County, WAWashington | $112.71 | $88.12 |
| WisconsinWisconsin | $100.18 | $80.98 |
| West VirginiaWest Virginia | $100.69 | $83.27 |
| WyomingWyoming | $102.51 | $82.47 |
90836 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.
$97.96
$140.07
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $140.07 | 1 |
| AL | $98.54 | 1 |
| AR | $97.96 | 1 |
| AZ | $101.95 | 1 |
| CA | $105.89–$122.34 | 29 |
| CO | $105.29 | 1 |
| CT | $107.38 | 1 |
| DC | $112.42 | 1 |
| DE | $102.96 | 1 |
| FL | $103.32–$108.44 | 3 |
| GA | $100.69–$104.41 | 2 |
| GU | $105.93 | 1 |
| HI | $105.93 | 1 |
| IA | $99.21 | 1 |
| ID | $99.56 | 1 |
| IL | $102.27–$107.32 | 4 |
| IN | $99.79 | 1 |
| KS | $99.19 | 1 |
| KY | $99.87 | 1 |
| LA | $99.87–$101.92 | 2 |
| MA | $105.31–$111.33 | 2 |
| MD | $104.05–$112.42 | 3 |
| ME | $99.95–$101.97 | 2 |
| MI | $101.11–$104.06 | 2 |
| MN | $102.14 | 1 |
| MO | $99.27–$101.87 | 3 |
| MS | $98.61 | 1 |
| MT | $103.20 | 1 |
| NC | $100.36 | 1 |
| ND | $101.62 | 1 |
| NE | $99.39 | 1 |
| NH | $104.03 | 1 |
| NJ | $108.95–$112.45 | 2 |
| NM | $101.42 | 1 |
| NV | $102.79 | 1 |
| NY | $101.01–$115.44 | 5 |
| OH | $100.79 | 1 |
| OK | $99.61 | 1 |
| OR | $102.30–$106.80 | 2 |
| PA | $100.76–$106.18 | 2 |
| PR | $103.48 | 1 |
| RI | $105.22 | 1 |
| SC | $100.68 | 1 |
| SD | $101.43 | 1 |
| TN | $99.42 | 1 |
| TX | $100.49–$104.68 | 8 |
| UT | $101.25 | 1 |
| VA | $101.95–$112.42 | 2 |
| VI | $103.48 | 1 |
| VT | $101.61 | 1 |
| WA | $105.00–$112.71 | 2 |
| WI | $100.18 | 1 |
| WV | $100.69 | 1 |
| WY | $102.51 | 1 |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,532
- Code
- 90836
- Physician work
- 2.17
- Practice expense
- 0.84
- Malpractice
- 0.08
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.17 | × 1.000 | 2.1700 |
| Practice expense | 0.84 | × 1.000 | 0.8400 |
| Malpractice | 0.08 | × 0.336 | 0.0269 |
| Total RVUs | 3.0369 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$101.43
Office: (2.17 × 1 + 0.84 × 1 + 0.08 × 0.336) × $33.4009 = $101.43
Facility: (2.17 × 1 + 0.24 × 1 + 0.08 × 0.336) × $33.4009 = $81.39
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. |
How 90836 has changed in South Dakota
90836 · Office / nonfacility
$101.43
Effective 2026-10-01
The base rate is $10.52 higher than on 2025-10-01, moving from $90.91 to $101.43 (11.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$90.91changed to$101.43
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.08 changed to 2.17
- Practice expense RVU 0.70 changed to 0.84
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$89.23changed to$90.91
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 1.99 changed to 2.08
- Practice expense RVU 0.66 changed to 0.70
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$87.77changed to$89.23
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$86.38changed to$87.77
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 1.90 changed to 1.99
- Practice expense RVU 0.62 changed to 0.66
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$88.17changed to$86.38
- Conversion factor 34.6062 changed to 33.8872
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$88.66changed to$88.17
- Conversion factor 34.8931 changed to 34.6062
- Malpractice RVU 0.06 changed to 0.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$90.56changed to$88.66
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.58 changed to 0.62
- Malpractice RVU 0.08 changed to 0.06
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$87.98changed to$90.56
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.51 changed to 0.58
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$85.36changed to$87.98
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.44 changed to 0.51
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$82.60changed to$85.36
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.37 changed to 0.44
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$82.42changed to$82.60
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$82.22changed to$82.42
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.36 changed to 0.37
- Malpractice RVU 0.07 changed to 0.08
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$81.81changed to$82.22
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$82.36changed to$81.81
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.37 changed to 0.36
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$66.21changed to$82.36
- Conversion factor 34.0230 changed to 35.8228
- Work RVU 1.60 changed to 1.90
- Practice expense RVU 0.32 changed to 0.37
- Malpractice RVU 0.06 changed to 0.07
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $66.21
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $101.43 | $81.39 | RVU26D |
| 2026-07-01 | $101.43 | $81.39 | RVU26C |
| 2026-04-01 | $101.43 | $81.39 | RVU26B |
| 2026-01-01 | $101.43 | $81.39 | RVU26A |
| 2025-10-01 | $90.91 | $80.24 | RVU25D |
| 2025-07-01 | $90.91 | $80.24 | RVU25C |
| 2025-04-01 | $90.91 | $80.24 | RVU25B |
| 2025-01-01 | $90.91 | $80.24 | RVU25A |
| 2024-10-01 | $89.23 | $79.24 | RVU24D |
| 2024-07-01 | $89.23 | $79.24 | RVU24C |
| 2024-04-01 | $89.23 | $79.24 | RVU24B |
| 2024-03-09 | $89.23 | $79.24 | RVU24AR |
| 2024-01-01 | $87.77 | $77.95 | RVU24A |
| 2023-10-01 | $86.38 | $76.89 | RVU23D |
| 2023-07-01 | $86.38 | $76.89 | RVU23C |
| 2023-04-01 | $86.38 | $76.89 | RVU23B |
| 2023-01-01 | $86.38 | $76.89 | RVU23A |
| 2022-10-01 | $88.17 | $78.48 | RVU22D |
| 2022-07-01 | $88.17 | $78.48 | RVU22C |
| 2022-04-01 | $88.17 | $78.48 | RVU22B |
| 2022-01-01 | $88.17 | $78.48 | RVU22A |
| 2021-10-01 | $88.66 | $78.89 | RVU21D |
| 2021-07-01 | $88.66 | $78.89 | RVU21C |
| 2021-04-01 | $88.66 | $78.89 | RVU21B |
| 2021-01-01 | $88.66 | $78.89 | RVU21A |
| 2020-10-01 | $90.56 | $82.26 | RVU20D |
| 2020-07-01 | $90.56 | $82.26 | RVU20C |
| 2020-04-01 | $90.56 | $82.26 | RVU20B |
| 2020-01-01 | $90.56 | $82.26 | RVU20A |
| 2019-10-01 | $87.98 | $82.21 | RVU19D |
| 2019-07-01 | $87.98 | $82.21 | RVU19C |
| 2019-04-01 | $87.98 | $82.21 | RVU19B |
| 2019-01-01 | $87.98 | $82.21 | RVU19A |
| 2018-10-01 | $85.36 | $82.12 | RVU18D |
| 2018-07-01 | $85.36 | $82.12 | RVU18C |
| 2018-04-01 | $85.36 | $82.12 | RVU18B |
| 2018-01-01 | $85.36 | $82.12 | RVU18AR1 |
| 2017-10-01 | $82.60 | $81.88 | RVU17D |
| 2017-07-01 | $82.60 | $81.88 | RVU17C |
| 2017-04-01 | $82.60 | $81.88 | RVU17B |
| 2017-01-01 | $82.60 | $81.88 | RVU17A |
| 2016-10-01 | $82.42 | $81.71 | RVU16D |
| 2016-07-01 | $82.42 | $81.71 | RVU16C |
| 2016-04-01 | $82.42 | $81.71 | RVU16B |
| 2016-01-01 | $82.42 | $81.71 | RVU16A |
| 2015-10-01 | $82.22 | $81.86 | RVU15D |
| 2015-07-01 | $82.22 | $81.86 | RVU15C |
| 2015-04-01 | $81.81 | $81.45 | RVU15B |
| 2015-01-01 | $81.81 | $81.45 | RVU15A |
| 2014-10-01 | $82.36 | $81.64 | RVU14D |
| 2014-07-01 | $82.36 | $81.64 | RVU14C |
| 2014-04-01 | $82.36 | $81.64 | RVU14B |
| 2014-01-01 | $82.36 | $81.64 | RVU14A |
| 2013-10-01 | $66.21 | $66.21 | RVU13D |
| 2013-07-01 | $66.21 | $66.21 | RVU13C |
| 2013-04-01 | $66.21 | $66.21 | RVU13B |
| 2013-01-01 | $66.21 | $66.21 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
Show the CMS file lines behind this rate
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