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CMS RVU26D · Effective 2026-10-01

90865 in Chico

Office / nonfacility

$177.14

Base rate per service

Facility setting

$115.64

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Psychiatric treatment

About 90865: Medication-assisted psychiatric interview

Reports a psychiatric interview or therapeutic session conducted in a medication-induced state to facilitate communication or access to difficult material.

Narcosynthesis involves medication producing an altered, relaxed state while a clinician conducts a focused psychiatric interview or therapeutic work. A psychiatrist typically performs the service, using the induced state to facilitate communication or discussion of material that may be difficult to address in an ordinary interview. CMS recorded a small number of office services for this code in 2024 and no facility services.

Select 90865 when the documented service is specifically medication-assisted psychiatric work in an induced state, rather than ordinary psychotherapy, psychoanalysis, or hypnotherapy. The record should identify the medication-assisted method, its psychiatric purpose, and the interview or treatment performed. Under the Medicare Physician Fee Schedule, payment valuation includes clinician work, practice expense, and malpractice expense; the supplied CMS data show separate office and facility practice-expense inputs for this code.

Where the value comes from

  • Work RVU2.84 · 56%
  • Practice expense (office) RVU2.14 · 42%
  • Malpractice RVU0.13 · 3%

116

Medicare services in 2024 · #4769 by national volume

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.

90865 compared with similar codes

Office rates for Chico, from the same CMS release.

90880

Hypnotherapy

$107.70

90880 is for hypnotherapy. Use 90865 when psychiatric interview or treatment is conducted in a medication-induced state.

90845

Psychoanalysis

Analytic treatment

$112.63

90845 represents psychoanalysis, not an interview or treatment conducted in a medication-induced state.

90870

Electroconvulsive therapy

$191.23

90870 is electroconvulsive therapy. It describes an electrical treatment procedure, not medication-assisted psychiatric interviewing.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 90865 is $177.65—$0.51 higher than the $177.14 rate in Chico. Both use the same code, release and participation basis.

90865 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $177.14

  2. Bakersfield

    $177.65

    $0.51 higher than Chico

  3. El Centro

    $177.16

    $0.02 higher than Chico

  4. Fresno

    $177.14

    The same base rate than Chico

  5. Hanford-Corcoran

    $177.14

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $186.19

    $9.05 higher than Chico

  7. Madera

    $177.14

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 90865 ranges from $158.49 in Arkansas to $220.80 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Modesto

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Napa

    California · 90865

    Office

    $197.25

    Facility

    $123.29

    $20.11 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 90865

    Office

    $184.71

    Facility

    $118.38

    $7.57 higher than Chico for the office setting.

  • Redding

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 90865

    Office

    $178.61

    Facility

    $117.11

    $1.47 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 90865

    Office

    $183.73

    Facility

    $118.47

    $6.59 higher than Chico for the office setting.

  • Salinas

    California · 90865

    Office

    $182.97

    Facility

    $117.93

    $5.83 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 90865

    Office

    $185.55

    Facility

    $118.43

    $8.41 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 90865

    Office

    $206.65

    Facility

    $127.53

    $29.51 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 90865

    Office

    $206.50

    Facility

    $127.38

    $29.36 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 90865

    Office

    $210.69

    Facility

    $129.78

    $33.55 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 90865

    Office

    $210.09

    Facility

    $129.17

    $32.95 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 90865

    Office

    $180.21

    Facility

    $116.30

    $3.07 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 90865

    Office

    $186.02

    Facility

    $117.85

    $8.88 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 90865

    Office

    $183.19

    Facility

    $117.76

    $6.05 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 90865

    Office

    $187.81

    Facility

    $118.90

    $10.67 higher than Chico for the office setting.

  • Stockton

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 90865

    Office

    $197.04

    Facility

    $123.08

    $19.90 higher than Chico for the office setting.

  • Visalia

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 90865

    Office

    $177.14

    Facility

    $115.64

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 90865

    Office

    $189.01

    Facility

    $122.91

    $11.87 higher than Chico for the office setting.

  • Miami

    Florida · 90865

    Office

    $180.25

    Facility

    $121.83

    $3.11 higher than Chico for the office setting.

  • Chicago

    Illinois · 90865

    Office

    $177.32

    Facility

    $120.93

    $0.18 higher than Chico for the office setting.

  • Manhattan

    New York · 90865

    Office

    $190.87

    Facility

    $125.67

    $13.73 higher than Chico for the office setting.

  • Alaska*

    Alaska · 90865

    Office

    $220.80

    Facility

    $161.04

    $43.66 higher than Chico for the office setting.

  • Alabama

    Alabama · 90865

    Office

    $159.86

    Facility

    $110.76

    $17.28 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 90865

    Office

    $158.49

    Facility

    $110.29

    $18.65 lower than Chico for the office setting.

  • Arizona

    Arizona · 90865

    Office

    $167.84

    Facility

    $113.46

    $9.30 lower than Chico for the office setting.

  • Colorado

    Colorado · 90865

    Office

    $175.44

    Facility

    $115.74

    $1.70 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 90865

    Office

    $178.99

    Facility

    $118.56

    $1.85 higher than Chico for the office setting.

  • Delaware

    Delaware · 90865

    Office

    $169.86

    Facility

    $114.42

    $7.28 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 90865

    Office

    $175.12

    Facility

    $118.27

    $2.02 lower than Chico for the office setting.

  • Rest Of Florida

    Florida · 90865

    Office

    $169.72

    Facility

    $116.07

    $7.42 lower than Chico for the office setting.

  • Atlanta

    Georgia · 90865

    Office

    $172.98

    Facility

    $115.97

    $4.16 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 90865

    Office

    $163.79

    Facility

    $113.74

    $13.35 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 90865

    Office

    $178.64

    Facility

    $114.84

    $1.50 higher than Chico for the office setting.

  • Iowa

    Iowa · 90865

    Office

    $161.98

    Facility

    $110.64

    $15.16 lower than Chico for the office setting.

  • Idaho

    Idaho · 90865

    Office

    $162.67

    Facility

    $111.05

    $14.47 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 90865

    Office

    $169.36

    Facility

    $117.74

    $7.78 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 90865

    Office

    $166.90

    Facility

    $115.67

    $10.24 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 90865

    Office

    $176.62

    Facility

    $119.00

    $0.52 lower than Chico for the office setting.

  • Indiana

    Indiana · 90865

    Office

    $163.23

    Facility

    $111.21

    $13.91 lower than Chico for the office setting.

  • Kansas

    Kansas · 90865

    Office

    $161.66

    Facility

    $110.94

    $15.48 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 90865

    Office

    $162.38

    Facility

    $112.49

    $14.76 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 90865

    Office

    $167.05

    Facility

    $114.25

    $10.09 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 90865

    Office

    $162.28

    Facility

    $112.62

    $14.86 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 90865

    Office

    $187.96

    Facility

    $120.96

    $10.82 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 90865

    Office

    $175.10

    Facility

    $116.02

    $2.04 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 90865

    Office

    $178.44

    Facility

    $118.23

    $1.30 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 90865

    Office

    $172.13

    Facility

    $115.34

    $5.01 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 90865

    Office

    $163.32

    Facility

    $111.69

    $13.82 lower than Chico for the office setting.

  • Southern Maine

    Maine · 90865

    Office

    $168.43

    Facility

    $112.82

    $8.71 lower than Chico for the office setting.

  • Detroit

    Michigan · 90865

    Office

    $171.16

    Facility

    $117.01

    $5.98 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 90865

    Office

    $165.02

    Facility

    $113.79

    $12.12 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 90865

    Office

    $169.69

    Facility

    $111.95

    $7.45 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 90865

    Office

    $166.22

    Facility

    $113.53

    $10.92 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 90865

    Office

    $167.26

    Facility

    $113.84

    $9.88 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 90865

    Office

    $160.70

    Facility

    $112.33

    $16.44 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 90865

    Office

    $159.61

    Facility

    $111.30

    $17.53 lower than Chico for the office setting.

  • Montana**

    Montana · 90865

    Office

    $170.67

    Facility

    $114.56

    $6.47 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 90865

    Office

    $164.32

    Facility

    $111.97

    $12.82 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 90865

    Office

    $168.10

    Facility

    $111.99

    $9.04 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 90865

    Office

    $162.47

    Facility

    $110.68

    $14.67 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 90865

    Office

    $173.07

    Facility

    $114.65

    $4.07 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 90865

    Office

    $188.39

    Facility

    $123.29

    $11.25 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 90865

    Office

    $181.47

    Facility

    $120.19

    $4.33 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 90865

    Office

    $165.62

    Facility

    $114.16

    $11.52 lower than Chico for the office setting.

  • Nevada**

    Nevada · 90865

    Office

    $170.02

    Facility

    $113.86

    $7.12 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 90865

    Office

    $193.98

    Facility

    $127.26

    $16.84 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 90865

    Office

    $182.65

    Facility

    $121.21

    $5.51 higher than Chico for the office setting.

  • Queens

    New York · 90865

    Office

    $191.68

    Facility

    $125.35

    $14.54 higher than Chico for the office setting.

  • Rest Of New York

    New York · 90865

    Office

    $165.82

    Facility

    $112.51

    $11.32 lower than Chico for the office setting.

  • Ohio

    Ohio · 90865

    Office

    $164.49

    Facility

    $113.26

    $12.65 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 90865

    Office

    $162.06

    Facility

    $111.95

    $15.08 lower than Chico for the office setting.

  • Portland

    Oregon · 90865

    Office

    $179.02

    Facility

    $116.68

    $1.88 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 90865

    Office

    $169.10

    Facility

    $113.21

    $8.04 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 90865

    Office

    $176.15

    Facility

    $117.74

    $0.99 lower than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 90865

    Office

    $164.58

    Facility

    $113.07

    $12.56 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 90865

    Office

    $171.40

    Facility

    $114.67

    $5.74 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 90865

    Office

    $174.37

    Facility

    $116.41

    $2.77 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 90865

    Office

    $164.59

    Facility

    $112.75

    $12.55 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 90865

    Office

    $167.80

    Facility

    $111.68

    $9.34 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 90865

    Office

    $162.16

    Facility

    $111.16

    $14.98 lower than Chico for the office setting.

  • Austin

    Texas · 90865

    Office

    $174.52

    Facility

    $115.15

    $2.62 lower than Chico for the office setting.

  • Beaumont

    Texas · 90865

    Office

    $163.94

    Facility

    $112.87

    $13.20 lower than Chico for the office setting.

  • Brazoria

    Texas · 90865

    Office

    $169.84

    Facility

    $114.23

    $7.30 lower than Chico for the office setting.

  • Dallas

    Texas · 90865

    Office

    $170.63

    Facility

    $114.74

    $6.51 lower than Chico for the office setting.

  • Fort Worth

    Texas · 90865

    Office

    $169.97

    Facility

    $114.64

    $7.17 lower than Chico for the office setting.

  • Galveston

    Texas · 90865

    Office

    $170.19

    Facility

    $114.47

    $6.95 lower than Chico for the office setting.

  • Houston

    Texas · 90865

    Office

    $172.57

    Facility

    $116.85

    $4.57 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 90865

    Office

    $166.61

    Facility

    $113.36

    $10.53 lower than Chico for the office setting.

  • Utah

    Utah · 90865

    Office

    $165.95

    Facility

    $113.20

    $11.19 lower than Chico for the office setting.

  • Virginia

    Virginia · 90865

    Office

    $168.19

    Facility

    $113.03

    $8.95 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 90865

    Office

    $171.40

    Facility

    $114.67

    $5.74 lower than Chico for the office setting.

  • Vermont

    Vermont · 90865

    Office

    $167.82

    Facility

    $112.27

    $9.32 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 90865

    Office

    $174.66

    Facility

    $115.57

    $2.48 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 90865

    Office

    $190.85

    Facility

    $122.00

    $13.71 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 90865

    Office

    $164.67

    Facility

    $110.92

    $12.47 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 90865

    Office

    $163.19

    Facility

    $114.42

    $13.95 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 90865

    Office

    $169.55

    Facility

    $113.44

    $7.59 lower than Chico for the office setting.

See how rates vary across the country

90865 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$158.49

$220.80

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$220.801
AL$159.861
AR$158.491
AZ$167.841
CA$177.14–$210.6929
CO$175.441
CT$178.991
DC$189.011
DE$169.861
FL$169.72–$180.253
GA$163.79–$172.982
GU$178.641
HI$178.641
IA$161.981
ID$162.671
IL$166.90–$177.324
IN$163.231
KS$161.661
KY$162.381
LA$162.28–$167.052
MA$175.10–$187.962
MD$172.13–$189.013
ME$163.32–$168.432
MI$165.02–$171.162
MN$169.691
MO$160.70–$167.263
MS$159.611
MT$170.671
NC$164.321
ND$168.101
NE$162.471
NH$173.071
NJ$181.47–$188.392
NM$165.621
NV$170.021
NY$165.82–$193.985
OH$164.491
OK$162.061
OR$169.10–$179.022
PA$164.58–$176.152
PR$171.401
RI$174.371
SC$164.591
SD$167.801
TN$162.161
TX$163.94–$174.528
UT$165.951
VA$168.19–$189.012
VI$171.401
VT$167.821
WA$174.66–$190.852
WI$164.671
WV$163.191
WY$169.551

Explore 90865 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 90865 in Chico, the physician’s office rate is $177.14 and the facility-setting rate is $115.64: a difference of $61.50.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 90865 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$194.85

$177.14 × 110% = $194.85

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 90865 in Chico.

PPRRVU2026_Oct_nonQPP.csv

11,543

Code
90865
Physician work
2.84
Practice expense
2.14
Malpractice
0.13

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 90865 in Chico
ComponentRVULocality factorAdjusted
Physician work2.84× 1.0172.8883
Practice expense2.14× 1.0962.3454
Malpractice0.13× 0.5360.0697
Total RVUs5.3034
Conversion factor× 33.4009

Office / nonfacility rate, Chico$177.14

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 90865 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.841.017
Practice expense2.141.096
Malpractice0.130.536

(2.84 × 1.017 + 2.14 × 1.096 + 0.13 × 0.536) × $33.4009 = $177.14

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.841.017
Practice expense0.461.096
Malpractice0.130.536

(2.84 × 1.017 + 0.46 × 1.096 + 0.13 × 0.536) × $33.4009 = $115.64

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

90865 · Office / nonfacility

$177.14

Effective 2026-10-01

The base rate is $16.93 higher than on 2025-10-01, moving from $160.21 to $177.14 (10.6%).

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

    $160.21changed to$177.14

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.82 changed to 2.14
    • Malpractice RVU 0.15 changed to 0.13
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $160.21

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$177.14$115.64RVU26D
2026-07-01$177.14$115.64RVU26C
2026-04-01$177.14$115.64RVU26B
2026-01-01$177.14$115.64RVU26A
2025-10-01$160.21$118.14RVU25D
2025-07-01$160.21$118.14RVU25C
2025-04-01$160.21$118.14RVU25B
2025-01-01$160.21$118.14RVU25A

90865 billing questions

How is 90865 different from ordinary psychotherapy?

The defining feature is psychiatric interview or therapeutic work conducted in a medication-induced state. A conventional psychotherapy session without that method is not narcosynthesis.

What documentation supports reporting 90865?

Document the medication-assisted method, the psychiatric purpose, and the interview or therapeutic work performed. A note describing only routine counseling does not establish this service.

Does 90865 require a primary-code pairing?

The supplied CMS facts do not identify 90865 as an add-on code or specify a required primary-code pairing.

Can a separate psychotherapy service be reported for the same encounter?

The record should distinguish any separately reported psychotherapy from the medication-assisted interview or treatment. Do not use a psychotherapy code to represent the narcosynthesis service itself.

Is 90865 selected by session length?

The supplied code facts do not specify a time threshold. Choose it based on the medication-induced method and psychiatric service documented, not a psychotherapy time interval.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 90865PPRRVU2026_Oct_nonQPP.csv, line 11,543 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet