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Massachusetts Behavioral Health Reimbursement Rates

Massachusetts behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.

Medicare 90837

$187.04

Medicaid 90837

$157.11

Commercial (est.)

$180.00$210.00

Medicare Locality Rates — CPT 90837

GPCI-adjusted Medicare psychotherapy rates by county and metro locality in Massachusetts.

LocalityMedicare 90837vs National
Massachusetts Metropolitan Boston$197.06+18%
Rest of Massachusetts$177.02+6%

Key CPT Code Rates — Massachusetts

CPT 90791

Diagnostic Evaluation

Medicare: $194.15

Medicaid: $163.09

CPT 90832

Psychotherapy, 30 min

Medicare: $96.14

Medicaid: $80.76

CPT 90834

Psychotherapy, 45 min

Medicare: $127.57

Medicaid: $107.16

CPT 90837

Psychotherapy, 60 min

Medicare: $187.04

Medicaid: $157.11

Medicaid in Massachusetts

Massachusetts Medicaid uses a managed care model. Published estimates approximate 84% of Medicare for key outpatient behavioral health CPT codes — actual fee schedule dollars vary by code and provider type.

Master's-level clinicians typically receive 75–80% of psychologist rates for identical psychotherapy CPT codes under most state Medicaid fee schedules.

Source: Massachusetts Medicaid fee schedule (effective 2026-01-01).

Explore Massachusetts Rates

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