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West Virginia Behavioral Health Reimbursement Rates

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

Medicare 90837

$155.31

Medicaid 90837

$93.19

Commercial (est.)

$100.00$135.00

Key CPT Code Rates — West Virginia

CPT 90791

Diagnostic Evaluation

Medicare: $161.22

Medicaid: $96.73

CPT 90832

Psychotherapy, 30 min

Medicare: $79.83

Medicaid: $47.90

CPT 90834

Psychotherapy, 45 min

Medicare: $105.93

Medicaid: $63.56

CPT 90837

Psychotherapy, 60 min

Medicare: $155.31

Medicaid: $93.19

Medicaid in West Virginia

West Virginia Medicaid uses a managed care model. Published estimates approximate 60% of Medicare for key outpatient behavioral health CPT codes — actual fee schedule dollars vary by code and provider type. West Virginia Medicaid psychotherapy rates are below national averages.

Master's-level clinicians typically receive 75–80% of psychologist rates for identical psychotherapy CPT codes under most state Medicaid fee schedules.

Source: West Virginia Medicaid fee schedule (effective 2026-01-01).

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