North Carolina Behavioral Health Reimbursement Rates
North Carolina behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.
Medicare 90837
$160.32
Medicaid 90837
$123.45
Commercial (est.)
$140.00–$170.00
Key CPT Code Rates — North Carolina
CPT 90791
Diagnostic Evaluation
Medicare: $166.42
Medicaid: $128.14
CPT 90832
Psychotherapy, 30 min
Medicare: $82.41
Medicaid: $63.45
CPT 90834
Psychotherapy, 45 min
Medicare: $109.34
Medicaid: $84.19
CPT 90837
Psychotherapy, 60 min
Medicare: $160.32
Medicaid: $123.45
Medicaid in North Carolina
North Carolina Medicaid uses a managed care model. Published estimates approximate 77% 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: North Carolina Medicaid fee schedule (effective 2026-01-01).
Explore North Carolina Rates
Use the interactive explorer below — pre-loaded for North Carolina.