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CPT code 90870: Electroconvulsive therapy2026 Medicare rate & RVUs in Iowa

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 Iowa, Medicare pays $172.10 for 90870 in the office and $95.70 when it’s performed in a hospital or facility.

$172.10Office (non-facility)
$95.70Hospital or facility
−5.5%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 Iowa
  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 Iowa 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. Iowa pays $172.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

90870 in Iowa vs other payment areas
  1. Iowa · this page$172.10
  2. Los Angeles, CA · California$201.93+$29.83
  3. Washington, DC area · District of Columbia$203.89+$31.79
  4. Miami, FL · Florida$190.55+$18.45
  5. Chicago, IL · Illinois$186.99+$14.89
  6. Manhattan, NY · New York$204.62+$32.52
  7. Alaska · Alaska$228.65+$56.55

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

Every other payment area

90870 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$168.79$95.72
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

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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 90870 in Iowa
ComponentRVULocality factorAdjusted
Physician work2.50× 1.0002.5000
Practice expense2.86× 0.9152.6169
Malpractice0.09× 0.3970.0357
Total RVUs5.1526
Conversion factor× 33.4009

Office rate, Iowa$172.10

Office: (2.5 × 1 + 2.86 × 0.915 + 0.09 × 0.397) × $33.4009 = $172.10

Facility: (2.5 × 1 + 0.36 × 0.915 + 0.09 × 0.397) × $33.4009 = $95.70

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, Iowa
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 Iowa

90870 · Office / nonfacility

$172.10

Effective 2026-10-01

The base rate is $14.45 higher than on 2025-10-01, moving from $157.65 to $172.10 (9.2%).

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

    $157.65changed to$172.10

    • 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
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $163.15changed to$157.65

    • 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

    $160.49changed to$163.15

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $163.61changed to$160.49

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.51 changed to 2.58
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $166.94changed to$163.61

    • 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
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $167.37changed to$166.94

    • 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

    $170.16changed to$167.37

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.40 changed to 2.49
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $168.76changed to$170.16

    • 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
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $168.58changed to$168.76

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $168.41changed to$168.58

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.38 changed to 2.36
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $168.27changed to$168.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.40 changed to 2.38
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $168.70changed to$168.27

    • 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

    $167.86changed to$168.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $167.16changed to$167.86

    • 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
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $166.74changed to$167.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.65 changed to 2.37
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $166.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$172.10$95.70RVU26D
2026-07-01$172.10$95.70RVU26C
2026-04-01$172.10$95.70RVU26B
2026-01-01$172.10$95.70RVU26A
2025-10-01$157.65$97.70RVU25D
2025-07-01$157.65$97.70RVU25C
2025-04-01$157.65$97.70RVU25B
2025-01-01$157.65$97.70RVU25A
2024-10-01$163.15$100.54RVU24D
2024-07-01$163.15$100.54RVU24C
2024-04-01$163.15$100.54RVU24B
2024-03-09$163.15$100.54RVU24AR
2024-01-01$160.49$98.90RVU24A
2023-10-01$163.61$101.94RVU23D
2023-07-01$163.61$101.94RVU23C
2023-04-01$163.61$101.94RVU23B
2023-01-01$163.61$101.94RVU23A
2022-10-01$166.94$103.85RVU22D
2022-07-01$166.94$103.85RVU22C
2022-04-01$166.94$103.85RVU22B
2022-01-01$166.94$103.85RVU22A
2021-10-01$167.37$104.71RVU21D
2021-07-01$167.37$104.71RVU21C
2021-04-01$167.37$104.71RVU21B
2021-01-01$167.37$104.71RVU21A
2020-10-01$170.16$108.62RVU20D
2020-07-01$170.16$108.62RVU20C
2020-04-01$170.16$108.62RVU20B
2020-01-01$170.16$108.62RVU20A
2019-10-01$168.76$108.62RVU19D
2019-07-01$168.76$108.62RVU19C
2019-04-01$168.76$108.62RVU19B
2019-01-01$168.76$108.62RVU19A
2018-10-01$168.58$108.83RVU18D
2018-07-01$168.58$108.83RVU18C
2018-04-01$168.58$108.83RVU18B
2018-01-01$168.58$108.83RVU18AR1
2017-10-01$168.41$108.20RVU17D
2017-07-01$168.41$108.20RVU17C
2017-04-01$168.41$108.20RVU17B
2017-01-01$168.41$108.20RVU17A
2016-10-01$168.27$107.96RVU16D
2016-07-01$168.27$107.96RVU16C
2016-04-01$168.27$107.96RVU16B
2016-01-01$168.27$107.96RVU16A
2015-10-01$168.70$108.17RVU15D
2015-07-01$168.70$108.17RVU15C
2015-04-01$167.86$107.63RVU15B
2015-01-01$167.86$107.63RVU15A
2014-10-01$167.16$108.36RVU14D
2014-07-01$167.16$108.36RVU14C
2014-04-01$167.16$108.36RVU14B
2014-01-01$167.16$108.36RVU14A
2013-10-01$166.74$103.97RVU13D
2013-07-01$166.74$103.97RVU13C
2013-04-01$166.74$103.97RVU13B
2013-01-01$166.74$103.97RVU13AR

Price 90870 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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 IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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