CPT code 90868: TMS treatment, per session2026 Medicare rate & RVUs in New York
Report 90868 for a transcranial magnetic stimulation treatment session after initial planning, when stimulation is delivered and managed.
CMS doesn’t publish an office rate for 90868 in New York.
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 90868 covers
The treating clinician delivers magnetic pulses with a coil positioned over the scalp, following initial treatment planning and motor-threshold determination. This is a subsequent TMS treatment session in psychiatric care, commonly for depression, and is generally provided in an outpatient setting.
Report one unit for each treatment session. Use 90867 for initial treatment planning and motor-threshold determination, and 90869 when motor-threshold redetermination is performed with treatment. Medicare lists 90868 as carrier-priced under the physician fee schedule: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Its 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
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 90868 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
How the 90868 rate is calculated
Each of 90868’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 · 90868
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 90868
The CMS indicators that decide how 90868 is paid alongside other services.
CMS payment indicators · 90868
TMS treatment, per session
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
90868 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 90867TMS treatmentInitial mapping and treatment
- 90867 is for initial treatment planning and motor-threshold determination. 90868 is for a subsequent treatment-delivery session.
- 90869TMS RedeterminationMotor Threshold
- 90869 applies when motor-threshold redetermination accompanies treatment; 90868 covers treatment delivery and management without that redetermination.
- 90870Electroconvulsive therapy
- 90870 describes electroconvulsive therapy, which uses electrical stimulation under anesthesia. 90868 is a transcranial magnetic stimulation session.
90868 billing questions
When should 90868 be used instead of 90867?
Use 90867 for initial TMS treatment planning and motor-threshold determination. Use 90868 for a subsequent session delivering and managing treatment.
How does 90868 differ from 90869?
90868 represents treatment delivery and management without motor-threshold redetermination. Use 90869 when the session includes motor-threshold redetermination with treatment.
How many units are reported for a TMS session?
Report one unit for each treatment session.
How does Medicare price 90868?
Medicare assigns carrier-priced status: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.
Can modifier 50 be used, or can an assistant at surgery be paid?
Bilateral adjustment does not apply, so modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code.
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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