New Jersey Behavioral Health Reimbursement Rates
New Jersey behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.
Medicare 90837
$183.70
Medicaid 90837
$101.04
Commercial (est.)
$180.00–$210.00
Medicare Locality Rates — CPT 90837
GPCI-adjusted Medicare psychotherapy rates by county and metro locality in New Jersey.
| Locality | Medicare 90837 | vs National |
|---|---|---|
| New Jersey Northern | $190.38 | +14% |
| Rest of New Jersey | $177.02 | +6% |
Key CPT Code Rates — New Jersey
CPT 90791
Diagnostic Evaluation
Medicare: $190.69
Medicaid: $104.88
CPT 90832
Psychotherapy, 30 min
Medicare: $94.42
Medicaid: $51.93
CPT 90834
Psychotherapy, 45 min
Medicare: $125.29
Medicaid: $68.91
CPT 90837
Psychotherapy, 60 min
Medicare: $183.70
Medicaid: $101.04
Medicaid in New Jersey
New Jersey Medicaid uses a managed care model. Published estimates approximate 55% of Medicare for key outpatient behavioral health CPT codes — actual fee schedule dollars vary by code and provider type. New Jersey Medicaid psychotherapy rates run well below Medicare despite high commercial market costs.
Master's-level clinicians typically receive 75–80% of psychologist rates for identical psychotherapy CPT codes under most state Medicaid fee schedules.
Source: New Jersey Medicaid fee schedule (effective 2026-01-01).
Explore New Jersey Rates
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