Billing code 90870: Electroconvulsive therapyMedicare rate & RVUs
Report this service for a psychiatrist-administered electroconvulsive treatment session using electrical stimulation to induce a therapeutic seizure under anesthesia.
Medicare pays $182.03 for 90870 nationally in the office and $98.53 in a hospital or facility. Local office rates run $167.11–$232.05.
Medicare rate · 90870
Electroconvulsive therapy
Swap in your local Medicare rate.
- Work RVUs
- 2.5
- Total RVUs
- 5.45
- Global days
- 000
National rate · 2026
$182.03
Office setting, before claim adjustments.
See every locality for 90870 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
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.
Where 90870 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$167.11 to $232.05
109 of 109 payment localities
90870 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $228.65 | 1 |
| AL | $168.79 | 1 |
| AR | $167.11 | 1 |
| AZ | $178.64 | 1 |
| CA | $191.23–$232.05 | 29 |
| CO | $188.49 | 1 |
| CT | $191.69 | 1 |
| DC | $203.89 | 1 |
| DE | $181.00 | 1 |
| FL | $179.34–$190.55 | 3 |
| GA | $172.30–$184.42 | 2 |
| GU | $193.86 | 1 |
| HI | $193.86 | 1 |
| IA | $172.10 | 1 |
| ID | $172.81 | 1 |
| IL | $175.42–$187.52 | 4 |
| IN | $173.52 | 1 |
| KS | $171.37 | 1 |
| KY | $171.18 | 1 |
| LA | $170.92–$176.81 | 2 |
| MA | $187.82–$203.66 | 2 |
| MD | $183.77–$203.89 | 3 |
| ME | $173.26–$180.07 | 2 |
| MI | $174.11–$180.75 | 2 |
| MN | $182.69 | 1 |
| MO | $168.77–$177.46 | 3 |
| MS | $167.97 | 1 |
| MT | $182.03 | 1 |
| NC | $174.55 | 1 |
| ND | $180.25 | 1 |
| NE | $172.81 | 1 |
| NH | $185.58 | 1 |
| NJ | $194.46–$202.78 | 2 |
| NM | $174.71 | 1 |
| NV | $181.63 | 1 |
| NY | $176.37–$208.01 | 5 |
| OH | $173.75 | 1 |
| OK | $171.14 | 1 |
| OR | $180.76–$193.20 | 2 |
| PA | $174.04–$188.03 | 2 |
| PR | $183.04 | 1 |
| RI | $186.45 | 1 |
| SC | $174.32 | 1 |
| SD | $180.04 | 1 |
| TN | $171.95 | 1 |
| TX | $173.22–$187.40 | 8 |
| UT | $176.00 | 1 |
| VA | $179.53–$203.89 | 2 |
| VI | $183.04 | 1 |
| VT | $179.59 | 1 |
| WA | $187.46–$207.34 | 2 |
| WI | $175.94 | 1 |
| WV | $170.82 | 1 |
| WY | $181.25 | 1 |
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
Swap in your local Medicare rate.
Work 2.50Practice expense 2.86Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 90870
The CMS indicators that decide how 90870 is paid alongside other services.
CMS payment indicators · 90870
Electroconvulsive therapy
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
90870 compared with similar codes
Compare codes
90870 vs 90868 vs 90867 vs 90837: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 90868Tcranial magn stim tx deli
- Use 90870 for an ECT session that induces a seizure under anesthesia; 90868 is for delivery of transcranial magnetic stimulation.
- 90867Tcranial magn stim tx plan
- 90867 reports planning and mapping for transcranial magnetic stimulation. It does not describe an ECT treatment session.
- 90837Psychotherapy
- 90837 is a time-based individual psychotherapy service. It does not include electrical seizure induction or ECT procedural care.
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
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