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CMS RVU26D · Effective 2026-10-01

90838 in Redding

Office / nonfacility

$139.93

Base rate per service

Facility setting

$111.01

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.

Psychotherapy

About 90838: Psychotherapy with E/M, 60 minutes

Report 90838 when a clinician provides at least 53 minutes of psychotherapy during the same encounter as a separately performed evaluation and management service.

This add-on represents an extended psychotherapy session delivered during the same encounter as an evaluation and management service. A psychiatrist or other qualified clinician may use it when addressing a patient’s psychiatric symptoms through psychotherapy while also providing separately identifiable E/M work, such as assessing symptoms or managing medication. Common settings include office visits and facility-based psychiatric encounters.

Select 90838 when psychotherapy time reaches at least 53 minutes; do not count time spent on the E/M service toward that threshold. The record should distinguish the psychotherapy from the E/M work and describe the issues addressed, therapeutic interventions, patient response, and plan. Report it only with an appropriate primary E/M service, not by itself. CMS classifies it as an add-on and pays it within the primary procedure’s global period.

CMS billing rules for 90838

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU2.86 · 70%
  • Practice expense (office) RVU1.11 · 27%
  • Malpractice RVU0.12 · 3%

94.1K

Medicare services in 2024 · #581 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.

90838 compared with similar codes

Office rates for Redding, from the same CMS release.

90837

Psychotherapy

60 minutes, no E/M

$172.69

90837 represents extended psychotherapy without an accompanying E/M service. Choose 90838 when a separately performed E/M service is also part of the encounter.

90836

Psychotherapy

With E/M, 38–52 minutes

$105.89

Both codes include psychotherapy with E/M, but 90836 is for a shorter psychotherapy duration. Use 90838 when psychotherapy reaches at least 53 minutes.

90833

Psychotherapy with E/M

Add-on, 30 minutes

$83.50

90833 is the shorter-duration psychotherapy-with-E/M option. 90838 requires at least 53 minutes of psychotherapy, separate from E/M time.

90839

Crisis psychotherapy

Initial 60 minutes

$165.71

90839 is for psychotherapy addressing an acute crisis. 90838 describes extended psychotherapy with an E/M service, not crisis psychotherapy.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 90838 is $140.42—$0.49 higher than the $139.93 rate in Redding. Both use the same code, release and participation basis.

90838 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $139.93

  2. Bakersfield

    $140.42

    $0.49 higher than Redding

  3. Chico

    $139.93

    The same base rate than Redding

  4. El Centro

    $139.95

    $0.02 higher than Redding

  5. Fresno

    $139.93

    The same base rate than Redding

  6. Hanford-Corcoran

    $139.93

    The same base rate than Redding

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

    $145.96

    $6.03 higher than Redding

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, 90838 ranges from $129.44 in Arkansas to $184.98 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

  • Madera

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Merced

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Modesto

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Napa

    California · 90838

    Office

    $152.45

    Facility

    $117.67

    $12.52 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 90838

    Office

    $144.52

    Facility

    $113.33

    $4.59 higher than Redding for the office setting.

  • Rest Of California

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 90838

    Office

    $141.30

    Facility

    $112.38

    $1.37 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 90838

    Office

    $144.23

    Facility

    $113.54

    $4.30 higher than Redding for the office setting.

  • Salinas

    California · 90838

    Office

    $143.61

    Facility

    $113.02

    $3.68 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 90838

    Office

    $144.91

    Facility

    $113.35

    $4.98 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 90838

    Office

    $158.72

    Facility

    $121.51

    $18.79 higher than Redding for the office setting.

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

    California · 90838

    Office

    $158.58

    Facility

    $121.38

    $18.65 higher than Redding for the office setting.

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

    California · 90838

    Office

    $161.64

    Facility

    $123.60

    $21.71 higher than Redding for the office setting.

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

    California · 90838

    Office

    $161.09

    Facility

    $123.04

    $21.16 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 90838

    Office

    $141.53

    Facility

    $111.47

    $1.60 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 90838

    Office

    $144.73

    Facility

    $112.67

    $4.80 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 90838

    Office

    $143.58

    Facility

    $112.81

    $3.65 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 90838

    Office

    $146.07

    Facility

    $113.67

    $6.14 higher than Redding for the office setting.

  • Stockton

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 90838

    Office

    $152.25

    Facility

    $117.47

    $12.32 higher than Redding for the office setting.

  • Visalia

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 90838

    Office

    $139.93

    Facility

    $111.01

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 90838

    Office

    $148.82

    Facility

    $117.74

    $8.89 higher than Redding for the office setting.

  • Miami

    Florida · 90838

    Office

    $144.26

    Facility

    $116.79

    $4.33 higher than Redding for the office setting.

  • Chicago

    Illinois · 90838

    Office

    $142.65

    Facility

    $116.14

    $2.72 higher than Redding for the office setting.

  • Manhattan

    New York · 90838

    Office

    $151.08

    Facility

    $120.42

    $11.15 higher than Redding for the office setting.

  • Alaska*

    Alaska · 90838

    Office

    $184.98

    Facility

    $156.88

    $45.05 higher than Redding for the office setting.

  • Alabama

    Alabama · 90838

    Office

    $130.24

    Facility

    $107.15

    $9.69 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 90838

    Office

    $129.44

    Facility

    $106.77

    $10.49 lower than Redding for the office setting.

  • Arizona

    Arizona · 90838

    Office

    $134.88

    Facility

    $109.31

    $5.05 lower than Redding for the office setting.

  • Colorado

    Colorado · 90838

    Office

    $139.25

    Facility

    $111.18

    $0.68 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 90838

    Office

    $142.22

    Facility

    $113.80

    $2.29 higher than Redding for the office setting.

  • Delaware

    Delaware · 90838

    Office

    $136.24

    Facility

    $110.17

    $3.69 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 90838

    Office

    $140.33

    Facility

    $113.60

    $0.40 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 90838

    Office

    $136.99

    Facility

    $111.77

    $2.94 lower than Redding for the office setting.

  • Atlanta

    Georgia · 90838

    Office

    $138.30

    Facility

    $111.49

    $1.63 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 90838

    Office

    $133.38

    Facility

    $109.84

    $6.55 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 90838

    Office

    $140.00

    Facility

    $110.00

    $0.07 higher than Redding for the office setting.

  • Iowa

    Iowa · 90838

    Office

    $131.04

    Facility

    $106.90

    $8.89 lower than Redding for the office setting.

  • Idaho

    Idaho · 90838

    Office

    $131.53

    Facility

    $107.26

    $8.40 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 90838

    Office

    $137.71

    Facility

    $113.43

    $2.22 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 90838

    Office

    $135.64

    Facility

    $111.55

    $4.29 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 90838

    Office

    $141.37

    Facility

    $114.27

    $1.44 higher than Redding for the office setting.

  • Indiana

    Indiana · 90838

    Office

    $131.84

    Facility

    $107.38

    $8.09 lower than Redding for the office setting.

  • Kansas

    Kansas · 90838

    Office

    $131.06

    Facility

    $107.21

    $8.87 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 90838

    Office

    $132.15

    Facility

    $108.70

    $7.78 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 90838

    Office

    $134.97

    Facility

    $110.14

    $4.96 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 90838

    Office

    $132.18

    Facility

    $108.83

    $7.75 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 90838

    Office

    $147.28

    Facility

    $115.77

    $7.35 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 90838

    Office

    $139.29

    Facility

    $111.50

    $0.64 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 90838

    Office

    $141.79

    Facility

    $113.48

    $1.86 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 90838

    Office

    $137.68

    Facility

    $110.98

    $2.25 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 90838

    Office

    $132.13

    Facility

    $107.85

    $7.80 lower than Redding for the office setting.

  • Southern Maine

    Maine · 90838

    Office

    $134.80

    Facility

    $108.65

    $5.13 lower than Redding for the office setting.

  • Detroit

    Michigan · 90838

    Office

    $138.06

    Facility

    $112.60

    $1.87 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 90838

    Office

    $133.90

    Facility

    $109.81

    $6.03 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 90838

    Office

    $134.86

    Facility

    $107.71

    $5.07 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 90838

    Office

    $134.26

    Facility

    $109.48

    $5.67 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 90838

    Office

    $134.84

    Facility

    $109.72

    $5.09 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 90838

    Office

    $131.39

    Facility

    $108.64

    $8.54 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 90838

    Office

    $130.41

    Facility

    $107.69

    $9.52 lower than Redding for the office setting.

  • Montana**

    Montana · 90838

    Office

    $136.60

    Facility

    $110.21

    $3.33 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 90838

    Office

    $132.68

    Facility

    $108.06

    $7.25 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 90838

    Office

    $134.23

    Facility

    $107.84

    $5.70 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 90838

    Office

    $131.26

    Facility

    $106.91

    $8.67 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 90838

    Office

    $137.63

    Facility

    $110.16

    $2.30 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 90838

    Office

    $148.83

    Facility

    $118.22

    $8.90 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 90838

    Office

    $144.23

    Facility

    $115.42

    $4.30 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 90838

    Office

    $134.34

    Facility

    $110.14

    $5.59 lower than Redding for the office setting.

  • Nevada**

    Nevada · 90838

    Office

    $135.98

    Facility

    $109.56

    $3.95 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 90838

    Office

    $153.17

    Facility

    $121.79

    $13.24 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 90838

    Office

    $145.27

    Facility

    $116.38

    $5.34 higher than Redding for the office setting.

  • Queens

    New York · 90838

    Office

    $151.24

    Facility

    $120.05

    $11.31 higher than Redding for the office setting.

  • Rest Of New York

    New York · 90838

    Office

    $133.57

    Facility

    $108.50

    $6.36 lower than Redding for the office setting.

  • Ohio

    Ohio · 90838

    Office

    $133.42

    Facility

    $109.33

    $6.51 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 90838

    Office

    $131.75

    Facility

    $108.19

    $8.18 lower than Redding for the office setting.

  • Portland

    Oregon · 90838

    Office

    $141.23

    Facility

    $111.91

    $1.30 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 90838

    Office

    $135.27

    Facility

    $108.99

    $4.66 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 90838

    Office

    $140.62

    Facility

    $113.15

    $0.69 higher than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 90838

    Office

    $133.35

    Facility

    $109.13

    $6.58 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 90838

    Office

    $136.96

    Facility

    $110.28

    $2.97 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 90838

    Office

    $139.22

    Facility

    $111.96

    $0.71 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 90838

    Office

    $133.19

    Facility

    $108.81

    $6.74 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 90838

    Office

    $133.95

    Facility

    $107.56

    $5.98 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 90838

    Office

    $131.38

    Facility

    $107.39

    $8.55 lower than Redding for the office setting.

  • Austin

    Texas · 90838

    Office

    $138.49

    Facility

    $110.58

    $1.44 lower than Redding for the office setting.

  • Beaumont

    Texas · 90838

    Office

    $132.99

    Facility

    $108.98

    $6.94 lower than Redding for the office setting.

  • Brazoria

    Texas · 90838

    Office

    $136.16

    Facility

    $110.01

    $3.77 lower than Redding for the office setting.

  • Dallas

    Texas · 90838

    Office

    $136.75

    Facility

    $110.47

    $3.18 lower than Redding for the office setting.

  • Fort Worth

    Texas · 90838

    Office

    $136.43

    Facility

    $110.42

    $3.50 lower than Redding for the office setting.

  • Galveston

    Texas · 90838

    Office

    $136.42

    Facility

    $110.22

    $3.51 lower than Redding for the office setting.

  • Houston

    Texas · 90838

    Office

    $138.62

    Facility

    $112.42

    $1.31 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 90838

    Office

    $134.33

    Facility

    $109.29

    $5.60 lower than Redding for the office setting.

  • Utah

    Utah · 90838

    Office

    $133.98

    Facility

    $109.17

    $5.95 lower than Redding for the office setting.

  • Virginia

    Virginia · 90838

    Office

    $134.80

    Facility

    $108.86

    $5.13 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 90838

    Office

    $136.96

    Facility

    $110.28

    $2.97 lower than Redding for the office setting.

  • Vermont

    Vermont · 90838

    Office

    $134.26

    Facility

    $108.14

    $5.67 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 90838

    Office

    $138.86

    Facility

    $111.07

    $1.07 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 90838

    Office

    $149.07

    Facility

    $116.69

    $9.14 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 90838

    Office

    $132.28

    Facility

    $107.00

    $7.65 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 90838

    Office

    $133.48

    Facility

    $110.55

    $6.45 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 90838

    Office

    $135.57

    Facility

    $109.18

    $4.36 lower than Redding for the office setting.

See how rates vary across the country

90838 · 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.

$129.44

$184.98

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$184.981
AL$130.241
AR$129.441
AZ$134.881
CA$139.93–$161.6429
CO$139.251
CT$142.221
DC$148.821
DE$136.241
FL$136.99–$144.263
GA$133.38–$138.302
GU$140.001
HI$140.001
IA$131.041
ID$131.531
IL$135.64–$142.654
IN$131.841
KS$131.061
KY$132.151
LA$132.18–$134.972
MA$139.29–$147.282
MD$137.68–$148.823
ME$132.13–$134.802
MI$133.90–$138.062
MN$134.861
MO$131.39–$134.843
MS$130.411
MT$136.601
NC$132.681
ND$134.231
NE$131.261
NH$137.631
NJ$144.23–$148.832
NM$134.341
NV$135.981
NY$133.57–$153.175
OH$133.421
OK$131.751
OR$135.27–$141.232
PA$133.35–$140.622
PR$136.961
RI$139.221
SC$133.191
SD$133.951
TN$131.381
TX$132.99–$138.628
UT$133.981
VA$134.80–$148.822
VI$136.961
VT$134.261
WA$138.86–$149.072
WI$132.281
WV$133.481
WY$135.571

Explore 90838 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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 90838 in Redding, the physician’s office rate is $139.93 and the facility-setting rate is $111.01: a difference of $28.92.

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 90838 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$153.92

$139.93 × 110% = $153.92

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 90838 in Redding.

PPRRVU2026_Oct_nonQPP.csv

11,534

Code
90838
Physician work
2.86
Practice expense
1.11
Malpractice
0.12

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 90838 in Redding
ComponentRVULocality factorAdjusted
Physician work2.86× 1.0172.9086
Practice expense1.11× 1.0961.2166
Malpractice0.12× 0.5360.0643
Total RVUs4.1895
Conversion factor× 33.4009

Office / nonfacility rate, Redding$139.93

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

Open 90838 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.861.017
Practice expense1.111.096
Malpractice0.120.536

(2.86 × 1.017 + 1.11 × 1.096 + 0.12 × 0.536) × $33.4009 = $139.93

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.861.017
Practice expense0.321.096
Malpractice0.120.536

(2.86 × 1.017 + 0.32 × 1.096 + 0.12 × 0.536) × $33.4009 = $111.01

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

90838 · Office / nonfacility

$139.93

Effective 2026-10-01

The base rate is $14.83 higher than on 2025-10-01, moving from $125.10 to $139.93 (11.9%).

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

    $125.10changed to$139.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.74 changed to 2.86
    • Practice expense RVU 0.93 changed to 1.11
    • Malpractice RVU 0.13 changed to 0.12
    • 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: $125.10

    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$139.93$111.01RVU26D
2026-07-01$139.93$111.01RVU26C
2026-04-01$139.93$111.01RVU26B
2026-01-01$139.93$111.01RVU26A
2025-10-01$125.10$110.26RVU25D
2025-07-01$125.10$110.26RVU25C
2025-04-01$125.10$110.26RVU25B
2025-01-01$125.10$110.26RVU25A

90838 billing questions

When should 90838 be chosen over 90837?

Use 90838 when the encounter includes at least 53 minutes of psychotherapy and a separately performed E/M service. Use 90837 for the corresponding extended psychotherapy service without E/M.

Can 90838 be billed by itself?

No. It is an add-on code and must be reported with an appropriate primary E/M service.

Does E/M time count toward the psychotherapy threshold?

No. Count psychotherapy time separately; time spent evaluating or managing the patient as part of the E/M service does not establish the psychotherapy duration.

What documentation supports reporting 90838?

Document the psychotherapy duration, the therapeutic work and patient response, and the separately performed E/M service. The record should make the two service components distinguishable.

Is 90838 an add-on within the primary service's global period?

Yes. CMS identifies 90838 as an add-on paid within the primary procedure’s global period, so report it with the qualifying primary service.

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 90838PPRRVU2026_Oct_nonQPP.csv, line 11,534 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet