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South Dakota Behavioral Health Reimbursement Rates

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

Medicare 90837

$160.32

Medicaid 90837

$129.86

Commercial (est.)

$100.00$135.00

Key CPT Code Rates — South Dakota

CPT 90791

Diagnostic Evaluation

Medicare: $166.42

Medicaid: $134.80

CPT 90832

Psychotherapy, 30 min

Medicare: $82.41

Medicaid: $66.75

CPT 90834

Psychotherapy, 45 min

Medicare: $109.34

Medicaid: $88.57

CPT 90837

Psychotherapy, 60 min

Medicare: $160.32

Medicaid: $129.86

Medicaid in South Dakota

South Dakota Medicaid uses a managed care model. Published estimates approximate 81% 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: South Dakota Medicaid fee schedule (effective 2026-01-01).

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