Commercial insurance pays therapists roughly $70–$172 per 60-minute session (CPT 90837) depending on the payer, contract, license, and location, based on CMS Transparency in Coverage filings. The 2026 Medicare benchmark is $167.00 for psychologists and about $125 for LCSWs/LMFTs/LMHCs. A commercial offer below your Medicare rate is worth negotiating before you sign.
Payers don't publish their fee schedules on a pricing page, so most therapists sign contracts without knowing whether the numbers are good. The data is public anyway: every payer is required to post contracted rates in machine-readable Transparency in Coverage files. This page pulls the numbers out of those files.
What do the major payers pay for 90837?
These are the 20th-to-80th percentile contracted rates for the four national networks, from the files payers publish under the CMS Transparency in Coverage rule:
| Session type | Aetna | Anthem BCBS | Cigna | UnitedHealthcare |
|---|---|---|---|---|
| 60-min therapy90837 | $118–$219 | $102–$172 | $68–$133 | $110–$154 |
| 45-min therapy90834 | $88–$182 | $76–$121 | $62–$94 | $75–$105 |
| Initial evaluation90791 | $140–$261 | $119–$193 | $65–$146 | $131–$179 |
| Family therapy90847 | $95–$186 | $86–$124 | $63–$105 | $92–$122 |
| Interactive add-on90785 | $13–$27 | $10–$16 | $3–$11 | $11–$15 |
Ranges are P20–P80 from CMS Transparency in Coverage data. Rates vary by state, locality, and contract negotiation. Look up rates by state, payer, and CPT code
Ranges this wide are the finding, not a limitation of the data. Cigna's band for CPT 90837 runs $68 to $151, so a therapist at the top of that band earns 2.2 times what a therapist at the bottom earns for the same hour, inside the same network. UnitedHealthcare's band is the narrowest at $110 to $154.
For your own state and payer, use the reimbursement rate lookup by state, payer, and CPT code. It has medians and typical ranges for every combination we track, which is a better answer than any national table.
What are the Medicare and Medicaid benchmarks?
Medicare's 2026 national non-facility rates are the cleanest yardstick, because CMS publishes them to the penny and pays master's-level clinicians at a statutory 75% of the fee schedule:
| CPT code | Psychologist (100%) | LCSW / LMFT / LMHC (75%) |
|---|---|---|
| 90791 (initial evaluation) | $173.35 | $130.01 |
| 90834 (45-min therapy) | $113.90 | $85.43 |
| 90837 (60-min therapy) | $167.00 | $125.25 |
The national number moves up or down by region, so look up your own locality's exact figures in the CMS Physician Fee Schedule tool.
Medicaid is the low anchor. A national study of Medicaid psychiatric reimbursement found states paying anywhere from 46% of the Medicare rate (Pennsylvania) to 234% (Nebraska) for the same services, with most states well below Medicare. If you're weighing a Medicaid panel, pull your state's published fee schedule before assuming anything.
How are therapy reimbursement rates set?
Almost every rate you'll be offered is anchored to Medicare. CMS publishes the Physician Fee Schedule each year, assigning every CPT code a relative value multiplied by a dollar conversion factor. Commercial payers then build their behavioral health fee schedules as a percentage of that number, sometimes above it, sometimes below.
That anchoring is why the Medicare rate matters even if you never see a Medicare client. When a payer offers you $95 for CPT 90837, the useful question is what percent of Medicare that is for your license in your ZIP code, not whether $95 sounds like a lot.
Why do LCSWs and PhDs get different rates?
Because Medicare pays clinical social workers, marriage and family therapists, and mental health counselors at 75% of the Physician Fee Schedule, and commercial payers copy the tiering. Some payers tier explicitly, with separate psychologist and master's-level fee schedules; others quietly pay a blended rate. Your license tier is one of the few things on a fee schedule you can't negotiate, which makes it more important to negotiate the things you can.
Does location change what insurance pays?
Yes, meaningfully. Medicare applies a Geographic Practice Cost Index (GPCI) to every locality, so the same 90837 pays more in Manhattan than in rural Mississippi. Because commercial contracts reference Medicare, the geography flows through to private rates too. High-cost metros commonly run 15–25% above the national figure; rural localities can sit below it. Never compare your offer to a national average without adjusting for where you practice.
Telehealth doesn't move you to a better locality. Rates are generally tied to where the service is rendered or where you're contracted, not to the highest-paying state your clients live in.
How do you know if your contracted rate is bad?
Compare it to Medicare first. Commercial payers pay their better contracts at or above Medicare for behavioral health, so an offer under your Medicare rate for the same code usually means you were handed the default schedule, the one they send when nobody pushes back. Ask for their best rate in writing before you countersign.
The expensive mistake is signing without seeing the fee schedule at all. Fee schedules are available on request before you sign, but payers don't volunteer them, and once the contract is effective most payers won't open a rate review until twelve months in. A first EOB paying $71 on a 90837, against a $125 Medicare benchmark, is a number you then live with for a year.
If your rates are below benchmark, you have options: a rate review request (see how to negotiate insurance reimbursement rates), shifting your caseload toward the payers that pay you best, or rebalancing toward private pay. The math for that is in insurance vs. private pay.
What should you check before signing a fee schedule?
Before countersigning any payer contract, get the fee schedule in writing and check:
- The actual dollar amount for 90837, 90834, and 90791, not "percent of our standard rate." If they quote a percentage, ask: a percentage of what dollar figure?
- Your license tier. Confirm whether the schedule shown is for your license (LCSW/LMFT/LMHC vs PhD/PsyD). Payers routinely send the wrong tier.
- The Medicare comparison. Look up 90837 for your locality and license at the CMS Physician Fee Schedule tool. If the offer is below that number, ask for their best rate in writing before signing.
- Telehealth parity. Does 90837 via telehealth pay the same as in person? Get the answer in the contract, not on the phone.
- 90837 utilization policy. Ask whether 60-minute sessions trigger review letters (Optum/UHC are known for this) or whether they steer you to 90834.
- The add-on codes. 90785 (interactive complexity) and 90847 (family therapy) rates: small numbers, but they compound.
- Rate review window. When can you first request an increase, and to whom is the request addressed? Write the date in your calendar now.
- Effective date vs. loaded date. Confirm when you can actually bill. Approval, contract effective date, and being loaded in the claims system are three different dates.
One more comparison worth running before you sign anything: what the same caseload earns on a platform like Headway or Alma versus under your own contract. The per-session difference decides which model wins, and we've laid it out in Headway and Alma vs. getting credentialed yourself. For pulling your own contracts together, paneled.ai tracks each payer's fee schedule against these benchmarks as part of credentialing, so you see the number before you're locked into it.
Common questions
- How much does insurance pay for a 60-minute therapy session (90837)?
- For CPT 90837, the four major commercial payers mostly pay between about $70 and $172 per session depending on the contract, based on CMS Transparency in Coverage filings. Medicare's 2026 national rate is $167.00 for psychologists and about $125 for LCSWs, LMFTs, and LMHCs, who are paid at 75% of the fee schedule.
- Do LCSWs get paid less than psychologists by insurance?
- Under Medicare, yes. LCSWs, LMFTs, and LMHCs are paid 75% of the Physician Fee Schedule amount, so a 90837 that pays a psychologist $167.00 pays a master's-level clinician about $125.25 in 2026. Many commercial payers copy this tiering into their own fee schedules, though some pay all licenses the same rate.
- Is it a bad sign if an insurance contract pays less than Medicare?
- Usually. Commercial payers generally pay at or above Medicare for behavioral health, so an offer below your Medicare rate for the same code is a signal to push back before signing. Compare the offered 90837 rate to the CMS Physician Fee Schedule amount for your locality and license tier, then ask for the payer's best rate in writing.
- Why do two therapists in the same network get paid different rates?
- Contracted rates vary by license tier, geography, and when and how the contract was negotiated. Payer filings show wide internal spreads: the 20th and 80th percentile contracted rates for the same CPT code can differ by $40 to $80 within one network. The rate you sign at matters more than the payer's brand.
The paneled.ai team · Credentialing specialists. We file and track insurance credentialing applications for behavioral health providers every day — these guides come from what we see go wrong (and right) in real applications.