CPT90834

Psychotherapy (45 min) Cost in New York

Psytx w pt 45 minutes

$273Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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New York Medicare physician rate (2026)

+6.6% vs national

Average of 5 localities. Office range $112.31–$125.18.

New York (Hospital)
$96.80
Facility physician fee
Private plan est.
$158–$243
~130–200% of Medicare
Cash / self-pay est.
$97–$182
~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
$92
Only 34% 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 New York

New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

What psychotherapy (45 min) costs at hospitals near you

Everything above is a national average. The hospital you pick in New York 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 New York the office and hospital physician lines for this CPT differ by $24.59.

National vs New York

National office$113.90
National hospital (physician)$91.85
New York vs national7% above the national office rate of $113.90

Where New York ranks for this CPT

Rank (lowest physician fee first)#47 of 51
Lowest stateArkansas ($109.66)
Highest stateAlaska ($158.15)

CPT 90834 by New York locality

LocalityOffice
nyc suburbs/long island$125.18
queens$124.71
manhattan$124.25
poughkpsie/n nyc suburbs$120.52
rest of new york$112.31

PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.

Psychotherapy (45 min) and how New York is priced

New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.

New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.

This procedure: This is a standard individual psychotherapy session of about 45 minutes, the most commonly billed therapy length in the United States. You meet one-on-one with a therapist, in person or by video, to work on concerns such as anxiety, depression, or life stressors using approaches like cognitive behavioral therapy. Care typically involves weekly or biweekly sessions over months, so the per-session price compounds into a meaningful recurring expense.

What Is Psychotherapy (45 min)?

This is a standard individual psychotherapy session of about 45 minutes, the most commonly billed therapy length in the United States. You meet one-on-one with a therapist, in person or by video, to work on concerns such as anxiety, depression, or life stressors using approaches like cognitive behavioral therapy. Care typically involves weekly or biweekly sessions over months, so the per-session price compounds into a meaningful recurring expense.

What Affects the Cost

  • Therapy is a recurring cost; the number of sessions over a course of care dwarfs any single session fee.
  • Cash-pay rates vary enormously by city and clinician credential, and many therapists operate entirely outside insurance.
  • In-network copays or coinsurance per session are often much lower than cash rates, when you can find an in-network therapist with openings.
  • The technical difference between this 45-minute code and the 60-minute 90837 changes both the charge and what insurers reimburse.
  • Sliding-scale fees, training clinics, and employer EAP sessions can reduce or eliminate cost for a set number of visits.

Questions to Ask Before Booking

  • 1.What is my per-session cost in network, and what would I actually get back if I see you out of network with a superbill?
  • 2.Do you offer a sliding scale or reduced rate if I pay cash?
  • 3.Does my employer EAP cover any sessions free before my insurance kicks in?
  • 4.How many sessions do you anticipate for my goals?
  • 5.What is your cancellation fee policy, since insurance will not pay those?

Psychotherapy (45 min) in New York: questions

The 2026 Medicare physician office rate for CPT 90834 averages $121.39 across 5 New York localities, from $112.31 in REST OF NEW YORK to $125.18 in NYC SUBURBS/LONG ISLAND. The hospital physician rate averages $96.80. Enter a ZIP for the exact locality.

Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $12.87 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $24 for the office physician line or $19 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.

No. $121.39 is only the physician's share. Adding Medicare's facility payment brings the total to about $273 in a hospital outpatient department. Anesthesia, pathology and other codes billed the same day are extra. New York ranks #47 of 51 states on the physician line (7% above the national office rate of $113.90).

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.