Medicare Behavioral Health Fee Schedule (Free CSV and PDF)

This is a free Medicare behavioral health fee schedule: diagnostic evaluations, individual psychotherapy, the psychotherapy add-ons used with an E/M visit, crisis, family and group therapy, psychological testing, health behavior services and collaborative care, each with its Medicare Physician Fee Schedule allowed amount in the office and in a facility. Leave the ZIP blank for national amounts or enter yours for your payment locality, choose a date of service, and download the sheet as a CSV or a print-ready PDF. No signup.

The sheet shows the full fee schedule amount for one service. That's the amount before any provider-type reduction. Clinical social workers, marriage and family therapists and mental health counselors are paid a reduced percentage of it, so their Medicare amount is lower than the number on the sheet. For your provider type, use Medicare reimbursement by provider type.

Who gets paid what: provider type changes the amount

The fee schedule amount is the starting point, not the answer for every clinician. Medicare sets each provider type's allowed amount as a share of it:

The regulation for the last two rows reads: "The fee schedule for clinical social worker, marriage and family therapist, and mental health counselor services is set at 75 percent of the amount determined for clinical psychologist services under the physician fee schedule." Medicare then pays 80% of that provider-specific amount after the deductible, and the patient owes 20%.

Not every provider type can bill every code on the sheet. Clinical psychologists, social workers, marriage and family therapists and mental health counselors can't bill E/M visits, so they can't bill 90792 or the E/M psychotherapy add-ons. For a per-code amount by provider type, with the rule behind it and the combinations that aren't billable, use Medicare reimbursement by provider type.

How to read the behavioral health fee sheet

Each row is a code, our plain-English name for it, and two amounts. Office is the non-facility rate, which includes the cost of running a practice. Facility is the lower rate when the place of service is a hospital, clinic or other facility Medicare pays separately for overhead. Enter your ZIP to reprice every row for your payment locality, and pick the date of service so the sheet uses the CMS release in effect then. More on the split: facility vs non-facility rates.

Why some codes show a status instead of a price

When CMS doesn't publish a national amount, the row shows a short status note instead of dropping out. In this preset, family psychotherapy without the patient present (90846) carries a restricted-coverage status: Medicare covers it only in limited circumstances, so the sheet doesn't show a national amount. Check your Medicare contractor's policy before scheduling it, and see 90846 vs 90847 for the family therapy coverage rules.

Using the % of Medicare column

Type a percentage in Your rate, % of Medicare to add a column at that share of each office amount: a plan paying 90% of Medicare, for example. It applies to the full amount on the sheet, so for a counselor or social worker contract that's written as a percentage of Medicare's rate for that clinician, start from the provider-type amount instead. To weigh a whole contract by how often you bill each code, use the contract check.

Useful even if you don't bill Medicare

Medicare's amounts are the benchmark the rest of the market prices against. Commercial contracts are often written or reviewed as a percentage of Medicare, and EAP rates and cash-pay fees get compared with the same numbers, so this sheet is where many therapists start when they set a self-pay rate, review a payer's offer or decide whether to enroll with Medicare. More on that in why therapists look up Medicare rates.

What's on the sheet and why

The preset is an editorial starting list for an outpatient behavioral health practice, not a ranking of the most-billed codes:

Add any other code with the search under the table, remove the ones you don't bill, or reset to the original list.

Behavioral health billing traps

Psychotherapy codes are chosen by minutes

90832, 90834 and 90837 are picked by face-to-face psychotherapy time, not the scheduled slot. Drag the marker to see where a session lands:

Compare what each step is worth before deciding how to schedule:

Where the lines fall and what reviewers check: 90832 vs 90834 and 90834 vs 90837.

The add-on codes need an E/M visit

90833, 90836 and 90838 are add-ons: they're only paid with a same-day E/M by the same practitioner, so they belong to physicians, nurse practitioners, clinical nurse specialists and physician assistants. CMS says clinical psychologists, social workers, marriage and family therapists and mental health counselors "cannot independently bill Medicare for E/M visits" (89 FR 97929), so they bill the standalone psychotherapy codes. The E/M level is chosen by medical decision making, and psychotherapy minutes exclude the E/M work. Billed alone, an add-on denies; its amount on the sheet only applies on top of a visit. See psychotherapy add-on codes for 99214 + 90833 and the other pairings.

Crisis codes stand alone

90839 covers the first hour of crisis psychotherapy and 90840 each additional 30 minutes. Don't bill them with other psychotherapy, a diagnostic evaluation or interactive complexity on the same day. For the full rules, see psychotherapy CPT codes.

Need a sheet built around your codes and contracts?

The free sheet starts from our list and the full fee schedule amount. If you want one built from your own codes, at your locality, with your clinicians' provider types and your payers' rates side by side, you can request a custom fee sheet. Tell us the codes, location, clinicians and dates you need; we confirm the details and prepare it. It's a request we handle directly, not an upload or an automated contract analysis.

Sources: 42 CFR 414.20, 414.52(d), 414.56(c), 414.62 and 414.53 (88 FR 79530, Nov. 16, 2023), read on eCFR October 6, 2026; CY 2025 PFS final rule, 89 FR 97929 (E/M billing by CPs, CSWs, MFTs and MHCs); CMS Medicare Physician Fee Schedule relative value files (release shown on the sheet), including the restricted-coverage status for 90846. Verified October 6, 2026.