Illinois Behavioral Health Reimbursement Rates
Illinois behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.
Medicare 90837
$167.00
Medicaid 90837
$103.54
Commercial (est.)
$140.00–$170.00
Medicare Locality Rates — CPT 90837
GPCI-adjusted Medicare psychotherapy rates by county and metro locality in Illinois.
| Locality | Medicare 90837 | vs National |
|---|---|---|
| Illinois Chicago / Suburban Chicago | $180.36 | +8% |
| Cook County | $178.69 | +7% |
| Rest of Illinois | $158.65 | -5% |
Key CPT Code Rates — Illinois
CPT 90791
Diagnostic Evaluation
Medicare: $173.35
Medicaid: $107.48
CPT 90832
Psychotherapy, 30 min
Medicare: $85.84
Medicaid: $53.22
CPT 90834
Psychotherapy, 45 min
Medicare: $113.90
Medicaid: $70.62
CPT 90837
Psychotherapy, 60 min
Medicare: $167.00
Medicaid: $103.54
Medicaid in Illinois
Illinois Medicaid uses a managed care model. Published estimates approximate 62% of Medicare for key outpatient behavioral health CPT codes — actual fee schedule dollars vary by code and provider type. Illinois Medicaid psychotherapy rates remain below national Medicaid averages despite 2025 increases.
Master's-level clinicians typically receive 75–80% of psychologist rates for identical psychotherapy CPT codes under most state Medicaid fee schedules.
Source: Illinois Medicaid fee schedule (effective 2026-01-01).
Explore Illinois Rates
Use the interactive explorer below — pre-loaded for Illinois.