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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.

LocalityMedicare 90837vs 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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