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CPT code 90870: Electroconvulsive therapy2026 Medicare rate & RVUs in Washington, DC area

Report this service for a psychiatrist-administered electroconvulsive treatment session using electrical stimulation to induce a therapeutic seizure under anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality82.2K Medicare services in 2024

In Washington, DC area, Medicare pays $203.89 for 90870 in the office and $105.52 when it’s performed in a hospital or facility.

$203.89Office (non-facility)
$105.52Hospital or facility
+12.0%vs the national office rate ($182.03)

Check a contract rate as a % of Medicare · 90870 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 90870 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 90870 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 90870 covers

Electroconvulsive therapy (ECT) is a treatment session in which a clinician applies a brief electrical stimulus through scalp electrodes to produce a controlled seizure. A psychiatrist typically directs or performs the treatment for severe mood disorders, catatonia, or other psychiatric conditions when ECT is clinically selected. It is commonly delivered in a hospital or ambulatory procedure setting with anesthesia, muscle relaxation, and physiologic monitoring; anesthesia services are generally furnished by a separate anesthesia professional.

Report 90870 for the ECT treatment itself, not for psychotherapy or an entire course of treatment. The record should identify the treatment session and support that ECT was performed, including the clinical indication and procedural details. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. An assistant-at-surgery service is payable only when medical necessity is documented; 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.

How Washington, DC area compares for 90870

Across 109 of 109 payment localities, the office rate for 90870 runs from $167.11 in Arkansas to $232.05 in San Benito County, CA. Washington, DC area pays $203.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

90870 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$203.89
  2. Los Angeles, CA · California$201.93−$1.96
  3. Miami, FL · Florida$190.55−$13.34
  4. Chicago, IL · Illinois$186.99−$16.90
  5. Manhattan, NY · New York$204.62+$0.73
  6. Alaska · Alaska$228.65+$24.76
  7. Alabama · Alabama$168.79−$35.10

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

90870 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$167.11$95.38
ArizonaArizona$178.64$97.73
Bakersfield, CACalifornia$191.62$100.10
Chico, CACalifornia$191.23$99.71
El Centro, CACalifornia$191.25$99.73
Fresno, CACalifornia$191.23$99.71
Hanford, CACalifornia$191.23$99.71
Madera, CACalifornia$191.23$99.71

90870 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.

$167.11

$228.65

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

View every state and territory as a table
90870 office rate range by state
State / territoryOffice rate rangeLocalities
AK$228.651
AL$168.791
AR$167.111
AZ$178.641
CA$191.23–$232.0529
CO$188.491
CT$191.691
DC$203.891
DE$181.001
FL$179.34–$190.553
GA$172.30–$184.422
GU$193.861
HI$193.861
IA$172.101
ID$172.811
IL$175.42–$187.524
IN$173.521
KS$171.371
KY$171.181
LA$170.92–$176.812
MA$187.82–$203.662
MD$183.77–$203.893
ME$173.26–$180.072
MI$174.11–$180.752
MN$182.691
MO$168.77–$177.463
MS$167.971
MT$182.031
NC$174.551
ND$180.251
NE$172.811
NH$185.581
NJ$194.46–$202.782
NM$174.711
NV$181.631
NY$176.37–$208.015
OH$173.751
OK$171.141
OR$180.76–$193.202
PA$174.04–$188.032
PR$183.041
RI$186.451
SC$174.321
SD$180.041
TN$171.951
TX$173.22–$187.408
UT$176.001
VA$179.53–$203.892
VI$183.041
VT$179.591
WA$187.46–$207.342
WI$175.941
WV$170.821
WY$181.251

See 90870 in every payment locality

How the 90870 rate is calculated

Each of 90870’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 · 90870

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.50

2.50 RVUs× 1.000 GPCI

Practice expense2.86

2.86 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

5.4500

Conversion factor

$33.4009

Medicare rate

$182.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,547

Code
90870
Physician work
2.50
Practice expense
2.86
Malpractice
0.09

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 90870 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.50× 1.0542.6350
Practice expense2.86× 1.1783.3691
Malpractice0.09× 1.1130.1002
Total RVUs6.1043
Conversion factor× 33.4009

Office rate, Washington, DC area$203.89

Office: (2.5 × 1.054 + 2.86 × 1.178 + 0.09 × 1.113) × $33.4009 = $203.89

Facility: (2.5 × 1.054 + 0.36 × 1.178 + 0.09 × 1.113) × $33.4009 = $105.52

Open 90870 in the RVU calculator

Payment rules and modifiers for 90870

The CMS indicators that decide how 90870 is paid alongside other services.

CMS payment indicators · 90870

Electroconvulsive therapy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 90870

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

Codes related to 90870
CodeHow it relatesOffice range, Washington, DC area
Often billed with
00104ECT anesthesiaAnesthesia for ECT is commonly furnished and reported separately by the anesthesia professional.No office rate
Used instead
90867TMS treatment, initial mapping and treatmentTranscranial magnetic stimulation planning is a different treatment approach from ECT.No office rate
90868TMS treatment, per sessionTranscranial magnetic stimulation treatment is a non-ECT treatment approach.No office rate
90869TMS Redetermination, motor ThresholdThis reports TMS parameter redetermination, not an ECT session.No office rate

How 90870 has changed in Washington, DC area

90870 · Office / nonfacility

$203.89

Effective 2026-10-01

The base rate is $16.32 higher than on 2025-10-01, moving from $187.57 to $203.89 (8.7%).

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

    $187.57changed to$203.89

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.55 changed to 2.86
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $194.22changed to$187.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.58 changed to 2.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $191.05changed to$194.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $196.89changed to$191.05

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.51 changed to 2.58
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $203.01changed to$196.89

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.52 changed to 2.51
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $203.40changed to$203.01

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.49 changed to 2.52

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $204.55changed to$203.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.40 changed to 2.49
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.18changed to$204.55

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.36 changed to 2.40
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $200.96changed to$201.18

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $201.52changed to$200.96

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.38 changed to 2.36
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $202.20changed to$201.52

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.40 changed to 2.38
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $202.47changed to$202.20

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $201.47changed to$202.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $200.83changed to$201.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.37 changed to 2.40
    • Malpractice RVU 0.11 changed to 0.09
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $201.47changed to$200.83

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.65 changed to 2.37
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $201.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$203.89$105.52RVU26D
2026-07-01$203.89$105.52RVU26C
2026-04-01$203.89$105.52RVU26B
2026-01-01$203.89$105.52RVU26A
2025-10-01$187.57$109.30RVU25D
2025-07-01$187.57$109.30RVU25C
2025-04-01$187.57$109.30RVU25B
2025-01-01$187.57$109.30RVU25A
2024-10-01$194.22$112.48RVU24D
2024-07-01$194.22$112.48RVU24C
2024-04-01$194.22$112.48RVU24B
2024-03-09$194.22$112.48RVU24AR
2024-01-01$191.05$110.65RVU24A
2023-10-01$196.89$114.61RVU23D
2023-07-01$196.89$114.61RVU23C
2023-04-01$196.89$114.61RVU23B
2023-01-01$196.89$114.61RVU23A
2022-10-01$203.01$117.03RVU22D
2022-07-01$203.01$117.03RVU22C
2022-04-01$203.01$117.03RVU22B
2022-01-01$203.01$117.03RVU22A
2021-10-01$203.40$118.00RVU21D
2021-07-01$203.40$118.00RVU21C
2021-04-01$203.40$118.00RVU21B
2021-01-01$203.40$118.00RVU21A
2020-10-01$204.55$121.71RVU20D
2020-07-01$204.55$121.71RVU20C
2020-04-01$204.55$121.71RVU20B
2020-01-01$204.55$121.71RVU20A
2019-10-01$201.18$121.28RVU19D
2019-07-01$201.18$121.28RVU19C
2019-04-01$201.18$121.28RVU19B
2019-01-01$201.18$121.28RVU19A
2018-10-01$200.96$121.58RVU18D
2018-07-01$200.96$121.58RVU18C
2018-04-01$200.96$121.58RVU18B
2018-01-01$200.96$121.58RVU18AR1
2017-10-01$201.52$121.08RVU17D
2017-07-01$201.52$121.08RVU17C
2017-04-01$201.52$121.08RVU17B
2017-01-01$201.52$121.08RVU17A
2016-10-01$202.20$121.09RVU16D
2016-07-01$202.20$121.09RVU16C
2016-04-01$202.20$121.09RVU16B
2016-01-01$202.20$121.09RVU16A
2015-10-01$202.47$121.07RVU15D
2015-07-01$202.47$121.07RVU15C
2015-04-01$201.47$120.47RVU15B
2015-01-01$201.47$120.47RVU15A
2014-10-01$200.83$121.60RVU14D
2014-07-01$200.83$121.60RVU14C
2014-04-01$200.83$121.60RVU14B
2014-01-01$200.83$121.60RVU14A
2013-10-01$201.47$116.69RVU13D
2013-07-01$201.47$116.69RVU13C
2013-04-01$201.47$116.69RVU13B
2013-01-01$201.47$116.69RVU13AR

Price 90870 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

90870 billing questions

How does 90870 differ from transcranial magnetic stimulation?

90870 reports ECT, which uses electrical stimulation to induce a therapeutic seizure under anesthesia. Code 90868 reports a transcranial magnetic stimulation treatment session.

Can anesthesia be reported separately?

An anesthesia professional may report 00104 for anesthesia furnished for ECT when the service is performed and documented. Code 90870 reports the ECT treatment itself.

Does 90870 cover an entire course of ECT?

No. Report the code for each ECT treatment session performed, rather than for the overall course or treatment plan.

Should modifier 50 be appended for bilateral electrode placement?

No. CMS identifies bilateral adjustment as inappropriate for 90870, regardless of electrode placement.

When can an assistant-at-surgery service be paid?

CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted 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

Show the CMS file lines behind this rate
RVUs for 90870PPRRVU2026_Oct_nonQPP.csv, line 11,547 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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