CPT 90836 Psychiatry

How Much Does Psytx W Patient W E/m 45 Minutes Cost?

Also known as: Psytx w pt w e/m 45 min (CPT 90836)

A combined visit with medication management and a standard-length psychotherapy session.

Psytx W Patient W E/m 45 Minutes (CPT 90836) costs $83 at Medicare rates.

Medicare (Facility)
$83
CMS PFS 2026 national rate
Medicare Physician Fee (Office/Clinic)
$103
Non-facility setting

Patient Guide: Psytx W Patient W E/m 45 Minutes

What you need to know before your appointment

What to Expect

Your psychiatrist provides both medication review/adjustment and a full therapy session in one appointment.

How Long Does It Take?

45-60 minutes total

Common Reasons Doctors Order This

Ongoing psychiatric treatment combining medication and therapy, complex mental health conditions

How to Prepare

Bring medication list and note any side effects. Prepare topics to discuss in therapy.

Procedures Commonly Done Together

These procedures are frequently performed alongside Psytx w pt w e/m 45 min

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How to Reduce Your Cost for Psytx w pt w e/m 45 min

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($103) differs from the facility rate ($83). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.17
Work RVU
0.24
Practice Expense RVU
0.08
Malpractice RVU
3.09
Total RVU

Payment = Total RVU (3.09) x CF ($33.40) = $103

Frequently Asked Questions

How much does Psytx w pt w e/m 45 min cost?

The Medicare facility rate for Psytx w pt w e/m 45 min is $83. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Psytx w pt w e/m 45 min cost without insurance?

Without insurance, the cost of Psytx w pt w e/m 45 min can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Psytx w pt w e/m 45 min?

Most commercial health insurance plans and Medicare cover Psytx w pt w e/m 45 min when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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