$117.41
Both represent 38–52 minutes of psychotherapy. Choose 90836 when an E/M service is also performed and reported; choose 90834 when psychotherapy is provided without E/M.
On this page
CMS RVU26D · Effective 2026-10-01
90836 Psychotherapy Medicare reimbursement rates in Hawaii
Report 90836 for 38–52 minutes of individual psychotherapy performed with a separately documented evaluation and management service during the same encounter. Compare 90836 office and facility rates across CMS payment localities in Hawaii.
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.
What does Medicare pay for 90836 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$105.93
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$83.14
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Psychotherapy
About 90836: Psychotherapy with E/M, 45 minutes
Report 90836 for 38–52 minutes of individual psychotherapy performed with a separately documented evaluation and management service during the same encounter.
Code 90836 describes individual psychotherapy provided to a patient during an encounter that also includes evaluation and management. It is commonly reported by psychiatrists and other qualified clinicians for sessions addressing concerns such as depression, anxiety, trauma, or coping with illness, when the clinician also evaluates or manages the patient’s medical or psychiatric condition. The psychotherapy portion must last 38–52 minutes; time spent on the E/M service is separate from psychotherapy time.
Report 90836 only with an appropriate primary E/M code for the same encounter; it is not a stand-alone psychotherapy code. The note should support the psychotherapy time, focus, interventions, and patient response, as well as the distinct assessment and management work supporting the E/M service. CMS classifies 90836 as an add-on code and pays it within the primary procedure’s global period. Select the psychotherapy level by documented psychotherapy time, not by the total appointment length.
CMS billing rules for 90836
- 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 RVU2.17 · 70%
- Practice expense (office) RVU0.84 · 27%
- Malpractice RVU0.08 · 3%
402.1K
Medicare services in 2024 · #256 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.
90836 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$83.53
Both are psychotherapy add-ons used with E/M. 90833 is for a shorter psychotherapy time; 90836 requires 38–52 minutes.
$140.00
Both are psychotherapy add-ons used with E/M. 90838 is for a longer psychotherapy time than the 38–52 minutes reported with 90836.
$172.21
90837 reports longer-duration psychotherapy without an E/M add-on structure. Use 90836 for 38–52 minutes when a separately supported E/M service is also performed.
Compare 90836 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$105.93
Facility
$83.14
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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 90836 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
11,532
- Code
- 90836
- Physician work
- 2.17
- Practice expense
- 0.84
- Malpractice
- 0.08
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.17 | × 1.000 | 2.1700 |
| Practice expense | 0.84 | × 1.137 | 0.9551 |
| Malpractice | 0.08 | × 0.579 | 0.0463 |
| Total RVUs | 3.1714 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$105.93
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.17 | 1 |
| Practice expense | 0.84 | 1.137 |
| Malpractice | 0.08 | 0.579 |
(2.17 × 1 + 0.84 × 1.137 + 0.08 × 0.579) × $33.4009 = $105.93
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.17 | 1 |
| Practice expense | 0.24 | 1.137 |
| Malpractice | 0.08 | 0.579 |
(2.17 × 1 + 0.24 × 1.137 + 0.08 × 0.579) × $33.4009 = $83.14
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.
90836 billing questions
When should I choose 90836 instead of 90834?
Use 90836 when 38–52 minutes of psychotherapy are performed with an E/M service in the same encounter. Use 90834 for that psychotherapy time when it is reported without an E/M service.
Which primary service must accompany 90836?
Report it with an appropriate E/M code for the same encounter, such as a qualifying office or outpatient E/M service. The E/M work must be supported separately from the psychotherapy.
Can 90836 be billed by itself?
No. CMS identifies 90836 as an add-on code that must be billed with a primary procedure.
How should time be documented?
Document 38–52 minutes of psychotherapy and distinguish that time from time spent on E/M work. The total appointment length alone does not establish the psychotherapy level.
Does the E/M service need separate documentation?
Yes. The record should support the assessment and management work as well as the psychotherapy interventions, focus, and patient response.
Should modifier 25 be added to 90836?
90836 is the psychotherapy add-on, not a replacement for the primary E/M code. Modifier 25 does not replace the requirement to report and document the appropriate E/M 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.
11,52990832,,Psytx w pt 30 minutes,A,,1.94,0.62,,0.13,,0.01,2.57,2.08,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53090833,,Psytx w pt w e/m 30 min,A,,1.71,0.66,,0.19,,0.07,2.44,1.97,0,ZZZ,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53190834,,Psytx w pt 45 minutes,A,,2.56,0.83,,0.17,,0.02,3.41,2.75,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53290836,,Psytx w pt w e/m 45 min,A,,2.17,0.84,,0.24,,0.08,3.09,2.49,0,ZZZ,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53390837,,Psytx w pt 60 minutes,A,,3.78,1.20,,0.25,,0.02,5.00,4.05,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53490838,,Psytx w pt w e/m 60 min,A,,2.86,1.11,,0.32,,0.12,4.09,3.30,0,ZZZ,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53590839,,Psytx crisis initial 60 min,A,,3.58,1.19,,0.27,,0.03,4.80,3.88,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014