Virginia Behavioral Health Reimbursement Rates
Virginia behavioral health billing requires state-specific Medicaid enrollment, payer-specific authorization rules, and credential verification before claim submission.
Medicare 90837
$168.67
Medicaid 90837
$129.88
Commercial (est.)
$140.00–$170.00
Medicare Locality Rates — CPT 90837
GPCI-adjusted Medicare psychotherapy rates by county and metro locality in Virginia.
| Locality | Medicare 90837 | vs National |
|---|---|---|
| Northern Virginia (DC suburbs) | $183.70 | +10% |
| Rest of Virginia | $160.32 | -4% |
Key CPT Code Rates — Virginia
CPT 90791
Diagnostic Evaluation
Medicare: $175.08
Medicaid: $134.81
CPT 90832
Psychotherapy, 30 min
Medicare: $86.70
Medicaid: $66.76
CPT 90834
Psychotherapy, 45 min
Medicare: $115.04
Medicaid: $88.58
CPT 90837
Psychotherapy, 60 min
Medicare: $168.67
Medicaid: $129.88
Medicaid in Virginia
Virginia 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: Virginia Medicaid fee schedule (effective 2026-01-01).
Explore Virginia Rates
Use the interactive explorer below — pre-loaded for Virginia.