CPT90837

Psychotherapy (60 min) Cost in Massachusetts

Psytx w pt 60 minutes

$317Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Massachusetts Medicare physician rate (2026)

+5.1% vs national

Average of 2 localities. Office range $171.01–$179.88.

Massachusetts (Hospital)
$139.80
Facility physician fee
Private plan est.
$228–$351
~130–200% of Medicare
Cash / self-pay est.
$140–$263
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Physician fee alone
$135
Only 43% of the hospital total

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Massachusetts

Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.

What psychotherapy (60 min) costs at hospitals near you

Everything above is a national average. The hospital you pick in Massachusetts moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Massachusetts the office and hospital physician lines for this CPT differ by $35.65.

National vs Massachusetts

National office$167.00
National hospital (physician)$135.27
Massachusetts vs national5% above the national office rate of $167.00

Where Massachusetts ranks for this CPT

Rank (lowest physician fee first)#45 of 51
Lowest stateArkansas ($161.03)
Highest stateAlaska ($232.44)

CPT 90837 by Massachusetts locality

LocalityOffice
metropolitan boston$179.88
rest of massachusetts$171.01

PE GPCI ranges from 1.053 to 1.194 in Massachusetts. That index is why the same CPT is not one price statewide.

Psychotherapy (60 min) and how Massachusetts is priced

Massachusetts is priced through two localities: metro Boston and the rest of the state. Boston's locality carries clearly higher geographic adjustments, reflecting some of the highest medical wages and office costs in the nation, while Worcester, Springfield, and the Cape share the lower rest-of-state factors. The split means the fee schedule itself acknowledges what everyone in the state already knows about Boston prices. Even so, rest-of-state Massachusetts still prices above most of the country.

Boston has arguably the densest concentration of academic medical centers anywhere, and its teaching hospitals pull referrals from all of New England and beyond. That prestige comes with a high-cost market structure that state policymakers have scrutinized for years. Western Massachusetts operates more like a regional market centered on Springfield, and Cape and islands residents contend with seasonal capacity strain.

This procedure: This is an extended individual psychotherapy session of about 60 minutes, used when clinical work benefits from more time, such as trauma-focused therapies like EMDR or prolonged exposure, complex cases, or clients who simply progress better with longer sessions. The experience is the same as any therapy session, just longer, in office or via telehealth. Many private-practice therapists use this as their default session length.

What Is Psychotherapy (60 min)?

This is an extended individual psychotherapy session of about 60 minutes, used when clinical work benefits from more time, such as trauma-focused therapies like EMDR or prolonged exposure, complex cases, or clients who simply progress better with longer sessions. The experience is the same as any therapy session, just longer, in office or via telehealth. Many private-practice therapists use this as their default session length.

What Affects the Cost

  • The 60-minute code both charges and reimburses more than the 45-minute 90834, so session length is itself a cost decision.
  • Some insurers scrutinize routine use of the longer code and effectively pressure therapists toward 45-minute billing, affecting what is offered in network.
  • Trauma protocols that clinically require longer sessions can lock you into the higher per-session rate for an extended course.
  • Cash rates for 60-minute sessions in major metropolitan areas run well above national averages.
  • Weekly frequency at the higher session rate compounds fastest of the common therapy configurations.

Questions to Ask Before Booking

  • 1.Do you bill 45 or 60 minute sessions, and how does that change my cost per visit?
  • 2.Does my treatment approach genuinely need the longer session, or would 45 minutes serve?
  • 3.What is my plan's allowed amount for 90837 out of network?
  • 4.Has my insurer ever pushed back on your 60-minute billing, and what happens to my sessions if it does?
  • 5.Is telehealth billed at the same rate as in-person for the hour session?

Psychotherapy (60 min) in Massachusetts: questions

The 2026 Medicare physician office rate for CPT 90837 averages $175.45 across 2 Massachusetts localities, from $171.01 in REST OF MASSACHUSETTS to $179.88 in METROPOLITAN BOSTON. The hospital physician rate averages $139.80. Enter a ZIP for the exact locality.

Yes. CMS splits Massachusetts into 2 payment localities. For this CPT the office physician fee spans $8.87 from the lowest to highest locality. Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $35 for the office physician line or $28 for the hospital physician line in Massachusetts. Medigap may cover that 20%. This is not the hospital facility fee.

No. $175.45 is only the physician's share. Adding Medicare's facility payment brings the total to about $317 in a hospital outpatient department. Anesthesia, pathology and other codes billed the same day are extra. Massachusetts ranks #45 of 51 states on the physician line (5% above the national office rate of $167.00).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.