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Pennsylvania rates for HCPCS 90838

Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure)

Facilitymedian $112 · 10th–90th $95–$1480%20%10th90th$112Professionalmedian $110 · 10th–90th $85–$1660%10%20%10th90th$110$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $134.90
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $120.23
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $208.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $134.90
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $251.19
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $141.25
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $120.23
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $245.47
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $117.49 / $199.53
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $120.23 / $144.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $117.49 / $158.49
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $102.33 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $123.03 / $208.93