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CPT code 90836: Psychotherapy, with E/M, 38–52 minutes2026 Medicare rate & RVUs in Virginia

Report 90836 for 38–52 minutes of individual psychotherapy performed with a separately documented evaluation and management service during the same encounter.

CMS RVU26DEffective Oct 1, 2026One payment locality402.1K Medicare services in 2024

In Virginia, Medicare pays $101.95 for 90836 in the office and $82.25 when it’s performed in a hospital or facility.

$101.95Office (non-facility)
$82.25Hospital or facility
−1.2%vs the national office rate ($103.21)

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.

We’ll open 90836 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 90836 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 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 Virginia 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. Virginia pays $101.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

90836 in Virginia vs other payment areas
  1. Virginia · this page$101.95
  2. Los Angeles, CA · California$110.42+$8.47
  3. Washington, DC area · District of Columbia$112.42+$10.47
  4. Miami, FL · Florida$108.44+$6.49
  5. Chicago, IL · Illinois$107.32+$5.37
  6. Manhattan, NY · New York$113.96+$12.01
  7. Alaska · Alaska$140.07+$38.12

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

Every other payment area

90836 in every other Medicare payment locality
Payment localityOfficeFacility
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

90836 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.

$97.96

$140.07

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
90836 office rate range by state
State / territoryOffice rate rangeLocalities
AK$140.071
AL$98.541
AR$97.961
AZ$101.951
CA$105.89–$122.3429
CO$105.291
CT$107.381
DC$112.421
DE$102.961
FL$103.32–$108.443
GA$100.69–$104.412
GU$105.931
HI$105.931
IA$99.211
ID$99.561
IL$102.27–$107.324
IN$99.791
KS$99.191
KY$99.871
LA$99.87–$101.922
MA$105.31–$111.332
MD$104.05–$112.423
ME$99.95–$101.972
MI$101.11–$104.062
MN$102.141
MO$99.27–$101.873
MS$98.611
MT$103.201
NC$100.361
ND$101.621
NE$99.391
NH$104.031
NJ$108.95–$112.452
NM$101.421
NV$102.791
NY$101.01–$115.445
OH$100.791
OK$99.611
OR$102.30–$106.802
PA$100.76–$106.182
PR$103.481
RI$105.221
SC$100.681
SD$101.431
TN$99.421
TX$100.49–$104.688
UT$101.251
VA$101.95–$112.422
VI$103.481
VT$101.611
WA$105.00–$112.712
WI$100.181
WV$100.691
WY$102.511

See 90836 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 90836 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.17× 1.0002.1700
Practice expense0.84× 0.9830.8257
Malpractice0.08× 0.7060.0565
Total RVUs3.0522
Conversion factor× 33.4009

Office rate, Virginia$101.95

Office: (2.17 × 1 + 0.84 × 0.983 + 0.08 × 0.706) × $33.4009 = $101.95

Facility: (2.17 × 1 + 0.24 × 0.983 + 0.08 × 0.706) × $33.4009 = $82.25

Open 90836 in the RVU calculator

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

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 90836

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

Codes related to 90836
CodeHow it relatesOffice range, Virginia
Same family
90833Psychotherapy with E/M, add-on, 30 minutesPsychotherapy with E/M for a shorter psychotherapy time.$80.44
90838Psychotherapy, with E/M, 60 minutesPsychotherapy with E/M for a longer psychotherapy time.$134.80
Used instead
90834Psychotherapy session, 45 minutes, without E/MPsychotherapy without an accompanying E/M service for the same 38–52-minute time range.$113.23
Primary code
99213Office visit, established patient, low complexityA qualifying office E/M code that may serve as the primary service.$93.48
99214Office visit, established patient, moderate complexityA qualifying office E/M code that may serve as the primary service.$133.10

How 90836 has changed in Virginia

90836 · Office / nonfacility

$101.95

Effective 2026-10-01

The base rate is $10.30 higher than on 2025-10-01, moving from $91.65 to $101.95 (11.2%).

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

    $91.65changed to$101.95

    • 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
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $90.00changed to$91.65

    • 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.

  3. March 9, 2024

    RVU24AR

    $88.53changed to$90.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $87.42changed to$88.53

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $89.58changed to$87.42

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $89.70changed to$89.58

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $91.92changed to$89.70

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $89.21changed to$91.92

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.51 changed to 0.58
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $86.63changed to$89.21

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.44 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $83.75changed to$86.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.37 changed to 0.44
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $83.41changed to$83.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $83.06changed to$83.41

    • 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.

  13. July 1, 2015

    RVU15C

    $82.65changed to$83.06

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $83.00changed to$82.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.37 changed to 0.36
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $66.57changed to$83.00

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $66.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$101.95$82.25RVU26D
2026-07-01$101.95$82.25RVU26C
2026-04-01$101.95$82.25RVU26B
2026-01-01$101.95$82.25RVU26A
2025-10-01$91.65$81.15RVU25D
2025-07-01$91.65$81.15RVU25C
2025-04-01$91.65$81.15RVU25B
2025-01-01$91.65$81.15RVU25A
2024-10-01$90.00$80.18RVU24D
2024-07-01$90.00$80.18RVU24C
2024-04-01$90.00$80.18RVU24B
2024-03-09$90.00$80.18RVU24AR
2024-01-01$88.53$78.87RVU24A
2023-10-01$87.42$78.03RVU23D
2023-07-01$87.42$78.03RVU23C
2023-04-01$87.42$78.03RVU23B
2023-01-01$87.42$78.03RVU23A
2022-10-01$89.58$79.94RVU22D
2022-07-01$89.58$79.94RVU22C
2022-04-01$89.58$79.94RVU22B
2022-01-01$89.58$79.94RVU22A
2021-10-01$89.70$79.98RVU21D
2021-07-01$89.70$79.98RVU21C
2021-04-01$89.70$79.98RVU21B
2021-01-01$89.70$79.98RVU21A
2020-10-01$91.92$83.70RVU20D
2020-07-01$91.92$83.70RVU20C
2020-04-01$91.92$83.70RVU20B
2020-01-01$91.92$83.70RVU20A
2019-10-01$89.21$83.53RVU19D
2019-07-01$89.21$83.53RVU19C
2019-04-01$89.21$83.53RVU19B
2019-01-01$89.21$83.53RVU19A
2018-10-01$86.63$83.44RVU18D
2018-07-01$86.63$83.44RVU18C
2018-04-01$86.63$83.44RVU18B
2018-01-01$86.63$83.44RVU18AR1
2017-10-01$83.75$83.05RVU17D
2017-07-01$83.75$83.05RVU17C
2017-04-01$83.75$83.05RVU17B
2017-01-01$83.75$83.05RVU17A
2016-10-01$83.41$82.71RVU16D
2016-07-01$83.41$82.71RVU16C
2016-04-01$83.41$82.71RVU16B
2016-01-01$83.41$82.71RVU16A
2015-10-01$83.06$82.71RVU15D
2015-07-01$83.06$82.71RVU15C
2015-04-01$82.65$82.30RVU15B
2015-01-01$82.65$82.30RVU15A
2014-10-01$83.00$82.30RVU14D
2014-07-01$83.00$82.30RVU14C
2014-04-01$83.00$82.30RVU14B
2014-01-01$83.00$82.30RVU14A
2013-10-01$66.57$66.57RVU13D
2013-07-01$66.57$66.57RVU13C
2013-04-01$66.57$66.57RVU13B
2013-01-01$66.57$66.57RVU13AR

Price 90836 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 90836PPRRVU2026_Oct_nonQPP.csv, line 11,532 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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