New York Behavioral Health Reimbursement Rates
New York behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.
Medicare 90837
$190.38
Medicaid 90837
$167.53
Commercial (est.)
$180.00–$210.00
Medicare Locality Rates — CPT 90837
GPCI-adjusted Medicare psychotherapy rates by county and metro locality in New York.
| Locality | Medicare 90837 | vs National |
|---|---|---|
| Manhattan / NYC Metro | $203.74 | +22% |
| Long Island / Nassau-Suffolk | $193.72 | +16% |
| York Rest of State | $173.68 | +4% |
| Rest of New York | $167.00 | +0% |
Key CPT Code Rates — New York
CPT 90791
Diagnostic Evaluation
Medicare: $197.62
Medicaid: $173.90
CPT 90832
Psychotherapy, 30 min
Medicare: $97.86
Medicaid: $86.11
CPT 90834
Psychotherapy, 45 min
Medicare: $129.85
Medicaid: $114.26
CPT 90837
Psychotherapy, 60 min
Medicare: $190.38
Medicaid: $167.53
Medicaid in New York
New York Medicaid uses a managed care model. Published estimates approximate 88% 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: New York Medicaid fee schedule (effective 2026-01-01).
Explore New York Rates
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