CPT code 90863: Medication management, with psychotherapy2026 Medicare rate & RVUs in Missouri

CMS doesn’t publish an office rate for 90863 in Missouri.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 90863 covers

90863 represents pharmacologic management provided in conjunction with psychotherapy. The work includes reviewing medications and managing medication therapy, including prescribing when appropriate; it is not a stand-alone medication-management visit or psychotherapy alone. In CPT reporting, 90863 is an add-on service used with the applicable primary psychotherapy service. It is reported by the clinician furnishing the medication-management work as part of the psychotherapy encounter.

Medicare assigns 90863 status I, so this code is not valid for Medicare reporting or payment. Medicare uses a different code to report and pay for the service. For Medicare claims, report the service under the applicable Medicare code rather than submitting 90863. Its CPT add-on role does not make it a valid Medicare code.

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.

Where 90863 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.

How the 90863 rate is calculated

Each of 90863’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.

Payment rules and modifiers for 90863

90863 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

90863 compared with similar codes

How to choose

90833Psychotherapy with E/MAdd-on, 30 minutes

90833 reports psychotherapy with an evaluation and management service. 90863 identifies medication management provided with psychotherapy and is not valid for Medicare reporting.

90834Psychotherapy session45 minutes, without E/M

90834 reports a timed psychotherapy service without an evaluation and management service. 90863 identifies medication management provided alongside psychotherapy.

90837Psychotherapy60 minutes, no E/M

90837 reports a longer timed psychotherapy service without an evaluation and management service. It does not identify the medication-management work described by 90863.

Codes related to 90863

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

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

Open CMS sourceHow we calculate rates