Medicare Reimbursement by Provider Type: LCSW, NP, PA (2026)

Medicare reimbursement by provider type: LCSWs, LMFTs and LPCs get 75% of the fee schedule, NPs and PAs 85%, psychologists 100%. Check any code for your ZIP.

Updated CMS RVU26DFree · no account

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Medicare reimbursement depends on who bills the service, not only on the code. Medicare pays clinical social workers, marriage and family therapists and mental health counselors 75% of the fee schedule amount; nurse practitioners, physician assistants and clinical nurse specialists 85%; and clinical psychologists, physicians and certified nurse-midwives 100% (42 CFR 414.53, 414.52, 414.56, 414.62, 414.20 and 414.54).

Pick a code and the clinician whose NPI goes on the claim. The tool applies that percentage to the fee schedule amount for your ZIP, setting and date, compares every provider type, and says plainly when one can't bill the code.

Free tool · Medicare by provider type

What Medicare allows when your provider type bills the code

Service code

90837

Key takeaways

  • The percentage applies to the allowed amount; the patient's 20% coinsurance is figured from the reduced amount.
  • Psychologists, social workers, MFTs and counselors can't bill E/M, so not 90792 or the E/M psychotherapy add-ons either.
  • Therapy assistant services (CQ, CO) keep the full allowed amount; Medicare takes 15% off its own payment.
  • The percentages apply when the clinician bills under their own NPI, not incident-to.

Medicare reimbursement by provider type: the percentages

Every percentage is a share of the same number: the physician fee schedule amount for the code, locality, setting and date.

Provider type Share of the fee schedule amount What they can bill (on this tool) Rule
Physician (MD, DO), participating 100% Any payable code 42 CFR 414.20(a)
Clinical psychologist (PhD, PsyD) 100% Diagnostic evaluation, psychotherapy, crisis, family and group, health behavior services, neurobehavioral exams, psychological and neuropsychological testing, G0323 42 CFR 414.62
Clinical social worker (LCSW, LICSW) 75% Diagnostic evaluation, psychotherapy, crisis, family and group, health behavior services, G0323 42 CFR 414.53; Pub. 100-04 ch. 12 §150
Marriage and family therapist (LMFT) 75% Same as clinical social workers, for services from January 1, 2024 42 CFR 414.53; Pub. 100-04 ch. 12 §240
Mental health counselor (LPC, LMHC, LCPC) 75% Same as clinical social workers, for services from January 1, 2024 42 CFR 414.53; Pub. 100-04 ch. 12 §250
Nurse practitioner, clinical nurse specialist 85% Any payable code within scope, except assistant at surgery 42 CFR 414.56(c); Pub. 100-04 ch. 12 §120
Physician assistant (PA, PA-C) 85% Any payable code within scope, except assistant at surgery 42 CFR 414.52(d); Pub. 100-04 ch. 12 §110
Certified nurse-midwife 100% Any payable code within CNM scope (since 2011) 42 CFR 414.54(b); Pub. 100-04 ch. 12 §130.1
PT, OT or SLP in private practice 100%, office setting only One therapy service Pub. 100-04 ch. 5 §10
Registered dietitian, nutrition professional 85% Medical nutrition therapy only (97802, 97803, 97804, G0270, G0271) 42 CFR 414.64(a); Pub. 100-04 ch. 4 §300.4
Physician, non-participating 95% (limiting charge 115% of that) Any payable code 42 CFR 414.20(b), 414.48(b)
75%LCSW, LMFT, LPC/LMHC
85%NP, PA, CNS, dietitian
100%psychologist, physician, nurse-midwife

The 75% for social workers, MFTs and counselors is written as 75% of what a clinical psychologist is paid. Psychologists are paid 100% of the fee schedule, so the result is 75% of the fee schedule amount.

Sources: eCFR, 42 CFR §§414.20, 414.48, 414.52, 414.53, 414.54, 414.56, 414.62, 414.64; CMS Pub. 100-04, ch. 12 (Rev. 13753), ch. 5 and ch. 4 §300.4; CMS MLN1986542, Medicare & Mental Health Coverage (March 2026). Verified October 6, 2026.

Who can bill what

A percentage only matters if the provider type can bill the code. Three limits catch most practices:

  • No E/M for behavioral health clinicians. CMS says clinical psychologists, clinical social workers, MFTs and mental health counselors "cannot independently bill Medicare for E/M visits" (CY 2025 final rule, 89 FR 97929). That rules out office visits such as 99214, the diagnostic evaluation with medical services (90792), and the psychotherapy add-ons that report alongside an E/M visit (90833, 90836, 90838). The tool marks these "not billable by this provider type" instead of showing 75% of an E/M amount.
  • Testing is for psychologists and medical practitioners. CMS's mental health booklet lists physicians, psychologists, NPs, CNSs, PAs and nurse-midwives for psychological and neuropsychological testing such as 96130. It doesn't list social workers, MFTs or counselors, so the tool doesn't price testing for them.
  • Medical nutrition therapy is for dietitians only. "Only a registered dietitian or nutrition professional may provide the services" (42 CFR 410.134). Physicians and NPs get no amount for 97802.

Setting matters too. Social workers, MFTs, counselors and dietitians aren't paid under their own benefit for hospital inpatients (social workers and dietitians also not for SNF inpatients), so the tool prints that exclusion beside the facility amount. Therapists in private practice have no facility amount: Medicare doesn't pay them for hospital patients.

For the full list of mental health codes and how they differ, see psychotherapy billing codes.

What the amount means

The number the tool shows is the allowed amount for that provider type: the total Medicare recognizes for the service, before it is split between Medicare and the patient.

  • It includes the patient's 20% coinsurance. Medicare pays 80% of it once the deductible is met.
  • It isn't the remittance. Medicare's payment is lower than the allowed amount, and the 2% sequestration reduction comes off that payment. Neither is applied here.
  • It isn't a guarantee. A priced code doesn't mean the service is covered for a given patient, or that the clinician is enrolled with Medicare or eligible to bill it.

Credentials map to Medicare categories, but the map isn't enrollment. An LPC, LMHC or LCPC bills as a mental health counselor only after meeting Medicare's requirements and enrolling; the same goes for every other row.

Worked example: 90837 for each provider type

Here is the current national amount for 90837, the hour-long psychotherapy code. Switch to facility or enter a ZIP to see your locality.

Medicare rate · 90837

Psychotherapy

Swap in your local Medicare rate.

Work RVUs
3.78
Total RVUs
5.00
Global days
XXX

National rate · 2026

$167.00

Office setting, before claim adjustments.

See every locality for 90837 → · Billed by an NP, PA or therapist? →

That is what a clinical psychologist bills against, and the 100% row for physicians. From there:

  • An LCSW, LMFT or LPC billing under their own NPI is allowed 75% of the 90837 amount shown above.
  • A psychiatric NP or PA is allowed 85% of it.
  • A non-participating psychiatrist is allowed 95% of it, and can charge the patient up to 115% of that 95% figure when not accepting assignment.

Now change the code to 99214 in the tool. The NP row shows 85% of the office visit amount; the social worker, MFT, counselor and psychologist rows show "not billable", because none of them can bill E/M. Change it to 90834 and every behavioral health row is priced again.

Therapy assistants: CQ and CO

PTA and OTA services aren't a separate provider type with a lower allowed amount. When a service is furnished in whole or in part by an assistant, the claim carries CQ (PT) or CO (OT), the allowed amount stays the same, and Medicare cuts its own payment by 15%. CMS says the reduction "is taken from the paid amount, i.e., the actual amount paid not the MPFS allowed amount," after the multiple procedure reduction and coinsurance and right before sequestration.

CMS's own illustrative example in Transmittal R11129CP: an allowed amount of $100, coinsurance of $20, leaving $80; the 15% assistant reduction takes $12, leaving $68 before sequestration. The patient's coinsurance is still 20% of the full $100.

For a whole visit with several timed codes, the therapy MPPR calculator applies the 50% practice expense reduction. Therapy codes also need the GP modifier or GO/GN for the plan of care.

Sources: 42 CFR 410.59(a)(4), 410.60(a)(4); CMS Pub. 100-04, ch. 5 §§10, 20; Transmittal R11129CP (CR 12397, November 22, 2021). Verified October 6, 2026.

Incident-to billing is a different calculation

When a social worker or NP furnishes a service as auxiliary personnel and the claim goes out under a physician's NPI, the physician rate applies; under an NP or PA's NPI, 85%. Whether a service qualifies depends on supervision, setting and who started the plan of care, which a code and ZIP can't tell us. Social workers, MFTs and counselors can't have services billed incident to themselves, and medical nutrition therapy can't be billed incident to anyone.

So the tool answers one question only: what Medicare allows when the clinician bills under their own NPI. For the supervision rules, read incident-to billing.

Non-participating physicians

Participation is a status, not a provider type, so it sits in the tool as its own row. A non-participating physician's allowed amount is 95% of the participating amount (42 CFR 414.20(b)). When the physician doesn't accept assignment, they may charge the patient up to the limiting charge, 115% of that non-participating amount (42 CFR 414.48(b)). The limiting charge is a ceiling on the bill, not an allowed amount.

Combinations the tool won't price

Rather than fall back to the physician amount, the tool says why it has no answer:

Combination Why
Psychologist, LCSW, LMFT or LPC with E/M, 90792 or the E/M psychotherapy add-ons Can't independently bill E/M (89 FR 97929)
LCSW, LMFT or LPC with psychological testing Not among the practitioners CMS lists for testing
LMFT or LPC before January 1, 2024 Not a Medicare billing provider type before that date
Physician or NP with medical nutrition therapy Only dietitians and nutrition professionals may furnish it
Non-participating NP, PA, social worker or other non-physician No source states how the 95% combines with 85% or 75%
NP or PA with several therapy codes in one visit No source sets the order of the 85% and the therapy MPPR
NP or PA as assistant at surgery Already a fixed share of the surgeon's amount; applying 85% again would double count
Crisis G-codes for non-office community sites (G0017, G0018) Depend on a place of service the tool doesn't ask for
Codes with no national amount (status R, N, I and similar) Medicare publishes no fee schedule amount to apply a percentage to

Need a sheet for your provider mix and contracts?

A group with a psychologist, two LCSWs and a psychiatric NP needs one code list priced several ways at its own locality, next to what each commercial contract pays. Send us the codes you bill and who bills them, and we'll put the sheet together with you; see fee sheets. For a free starting list, use the behavioral health fee schedule.

FAQ

Does Medicare pay LCSWs less than psychologists?

Yes. For the same code in the same place, a clinical social worker's allowed amount is 75% of a clinical psychologist's, because 42 CFR 414.53 sets it at 75% of the psychologist amount and psychologists get 100% of the fee schedule. The patient's 20% coinsurance is figured from the lower amount.

What does Medicare pay an LCSW for 90837?

75% of the 90837 fee schedule amount for your locality and setting. Pick 90837 and "Clinical social worker" in the tool above, add your ZIP and date of service, and it shows the amount with the CMS release it came from. That figure includes the patient's coinsurance; Medicare's payment is 80% of it after the deductible.

Can an LPC bill Medicare?

Since January 1, 2024, licensed professional counselors who meet Medicare's mental health counselor requirements can enroll and bill Medicare directly. They're paid 75% of the fee schedule amount for the same mental health services as clinical social workers, and they can't bill E/M visits.

Do NPs get 85% for every service?

For services billed under their own NPI, yes, in every setting. Two exceptions: as assistant at surgery an NP gets 85% of the reduced assistant amount, not 85% of the surgeon's, and services billed incident to a physician go out under the physician's NPI at the physician rate.

Do marriage and family therapists get the same rate as LCSWs?

Yes. LMFTs, mental health counselors and clinical social workers all fall under 42 CFR 414.53 at 75% of the fee schedule amount, with the same code set.

Related: behavioral health fee schedule, psychotherapy billing codes, incident-to billing, GP modifier and the therapy MPPR calculator.

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