Washington Reimbursement Rates for Mental Health Providers [2025]
Enjoy learning your Washington mental health insurance reimbursement rates for therapy and mental health providers in 2025! Our goal with this article is to educate behavioral health providers in WA about the insurance companies and payment amounts for psychotherapy by insurance company and county or locality.
Washington Medicare Reimbursement Rates by Locality [2025]
You’ll note that Medicare does adjust reimbursement rates based on county and locality. These are 2025 Medicare reimbursement rates for CPT Code 90791 – Diagnostic Interview:
King County | $180.46 |
Rest of State | $168.72 |
Washington Medicaid Reimbursement Rates for Mental Health by CPT Code [2025]
Code | CPT Code Description | WA Medicaid Reimbursement Rate [2025] |
---|---|---|
90791 | Pyschiatric diagnositc evaluation | $149.54 |
90792 | Psychiatric diagnostic evaluation with medical services | $182.41 |
90832 | Psychotherapy 30 minutes with patient and/or family member | $78.45 |
90833 | Psychotherapy 30 minutes with patient and/or family member when performed with an evaluation and management service | $95.21 |
90834 | Psychotherapy 45 minutes with patient | $123.16 |
90836 | Psychotherapy 45 minutes with patient when performed with an evaluation and management service | $140.40 |
90837 | Psychotherapy 60 minutes with patient | $147.78 |
90838 | Psychotherapy 60 minutes with patient when performed with an evaluation and management service | $206.67 |
90846 | Family psychotherapy (w/o patient) | $124.39 |
90847 | Family psychotherapy (w/ patient) | $140.30 |
90849 | Multiple family group psychotherapy | $41.99 |
90853 | Group psychotherapy | $40.91 |
90889 | Preparation of reports of patient psychiatric status, hex, TX, or progress for other individuals, agencies, or ins. carriers | $52.29 |
96110 | Developmental testing, limited | $16.07 |
96116 | Neurobehavioral status exam, by physician or psychologist, per hour | $80.72 |
96121 | Neurobehavioral status exam | $53.02 |
96130 | Psychological testing evaluation services | $84.06 |
96131 | Psychological testing evaluation services | $60.67 |
96132 | Neuropsychological testing evaluation services | $91.23 |
96133 | Neuropsychological testing evaluation services | $69.70 |
96136 | Psychological or neuropsychological test administration and scoring | $30.56 |
96137 | Psychological or neuropsychological test administration and scoring | $28.26 |
96138 | Psychological or neuropsychological test administration and scoring | $25.24 |
96139 | Psychological or neuropsychological test administration and scoring | $25.94 |
96372 | Therapeutic, prophylactic or diagnostic injection | $19.17 |
99202 | New patient outpatient visit, total time 15-29 minutes | $83.42 |
99203 | New patient outpatient visit, total time 30-44 minutes | $124.73 |
99204 | New patient outpatient visit, total time 45-59 minutes | $176.99 |
99205 | New patient outpatient visit, total time 60-74 minutes | $225.65 |
99211 | Established patient outpatient visit, minimal presenting problem | $27.01 |
99212 | Established patient outpatient visit, total time 10-19 minutes | $49.20 |
99213 | Established patient outpatient visit, total time 20-29 minutes | $67.38 |
99214 | Established patient outpatient visit, total time 30-39 minutes | $105.96 |
99215 | Established patient outpatient visit, total time 40-54 minutes | $155.07 |
99304 | E&M, nursing facility, new patient, level 1 | $97.11 |
99305 | E&M, nursing facility, new patient, level 2 | $128.92 |
99306 | E&M, nursing facility, new patient, level 3 | $158.49 |
99307 | E&M, established patient, nursing facility, level 1 | $50.23 |
99308 | E&M, established patient, nursing facility, level 2 | $83.72 |
99309 | E&M, established patient, nursing facility, level 3 | $117.19 |
99310 | E&M, established patient, nursing facility, level 4 | $146.78 |
99324 | End Dated Effective 12/31/2022 | $70.90 |
99325 | End Dated Effective 12/31/2022 | $103.38 |
99326 | End Dated Effective 12/31/2022 | $149.13 |
99327 | End Dated Effective 12/31/2022 | $196.24 |
99328 | End Dated Effective 12/31/2022 | $242.90 |
99334 | End Dated Effective 12/31/2022 | $54.89 |
99335 | End Dated Effective 12/31/2022 | $86.46 |
99336 | End Dated Effective 12/31/2022 | $132.66 |
99337 | End Dated Effective 12/31/2022 | $195.33 |
99341 | Home visit, new patient | $40.15 |
99342 | Home visit, new patient | $57.77 |
99343 | End Dated Effective 12/31/2022 | $77.50 |
99344 | Home visit, new patient | $132.64 |
99345 | Home visit, new patient | $160.87 |
99347 | Home visit, ext. patient | $40.42 |
99348 | Home visit, ext. patient | $61.39 |
99349 | Home visit, ext. patient | $93.51 |
99350 | Home visit, ext. patient | $129.53 |
G0317 | See Mental Health Billing Guide for Details | $22.23 |
G0318 | See Mental Health Billing Guide for Details | $21.76 |
G2212 | See Mental Health Billing Guide for Details | $32.49 |
H0004 | Behavioral health counseling and therapy, per 15 minutes | $37.00 |
H0018 | Behavioral health; short term residential, w/o room and board, per diem | $272.23 |
H0019 | Behavioral health; long term residential, w/o room and board, per diem | $156.62 |
H0023 | Behavioral health outreach service | $112.96 |
H0025 | Behavioral health prevention education service | $9.78 |
H0030 | Behavioral health hotline service | $6.73 |
H0031 | Mental health assessment, by non-physician | $191.11 |
H0033 | Oral medication admin, direct observation | $10.70 |
H0034 | Medication training and support, per 15 minutes | $9.82 |
H0035 | Mental Health partial hospitalization, treatment, less than 24 hours - IOP/PHP program only effective 1/1/2024 | $203.03 |
H0036 | Comm psychiatric supportive treatment, face-to-face, per 15 minutes | $8.72 |
H0038 | Self-help/peer services, per 15 minutes | $15.01 |
H0040 | Assertive comm treatment program, per diem | $182.49 |
H0046 | Mental health services not otherwise specified | $34.22 |
H2011 | Crisis intervention service, per 15 minutes | $42.82 |
H2012 | Behavioral health day treatment, per hour | $16.57 |
H2014 | Skills training and development, per 15 minutes | $17.68 |
H2015 | comprehensive community support services, per 15 minutes | $18.63 |
H2017 | Psychosocial rehabiliation services, per 15 minutes | $17.70 |
H2019 | Therapeutic Behavioral Services, per 15 minutes | $36.35 |
H2022 | Comm-based wrap-around service, per diem | $53.92 |
H2027 | Psychoeducational service, per 15 minutes | $17.85 |
H2033 | Multisystemic therapy for juveniles, per 15 minutes | $20.90 |
S9446 | Patient education, nonphysician provider, group, per session | $7.36 |
S9480 | Intensive outpatient psychiatric services, per diem - IOP/PHP program only - effective 1/1/2024 | $196.40 |
S9480 | Intensive outpatient psychiatric services, per diem | $37.69 |
S9484 | Crisis intervention mental health services, per hour | $78.06 |
S9485 | Crisis intervention mental health services, per diem | $466.44 |
S9976 | Lodging | $14.20 |
T1001 | Nursing assessment/evaluation | $25.03 |
T2022 | New Journeys providers only - See Part II of the Mental Health Billing Guide for more details | $2,318.00 |
T2023 | New Journeys providers only - See Part II of the Mental Health Billing Guide for more details | $1,622.60 |
T1023 | Screening for appropriateness for spec program | $110.75 |
Mental Health Reimbursement Rates by CPT Code (2025)
CPT Code | Description | Medicare Reimbursement Rates 2024 | Medicare Reimbursement Rates 2025 |
---|---|---|---|
90791 | Psychological Diagnostic Evaluation | $169.29 | $166.91 |
90792 | Psychological Diagnostic Evaluation with Medication Management | $190.57 | $187.93 |
90832 | Individual Psychotherapy, 30 Minutes | $76.95 | $78.93 |
90833 | Individual Psychotherapy with Evaluation and Management Services, 30 minutes | $70.73 | $72.78 |
90834 | Individual Psychotherapy, 45 Minutes | $101.51 | $104.16 |
90836 | Individual Psychotherapy with Evaluation and Management Services, 45 minutes | $89.39 | $92.51 |
90837 | Individual Psychotherapy, 60 Minutes | $149.64 | $154.29 |
90838 | Individual Psychotherapy with Evaluation and Management Services, 60 minutes | $118.53 | $122.92 |
90839 | Individual Crisis Psychotherapy initial 60 min | $144.07 | $148.47 |
90840 | Individual Crisis Psychotherapy initial 60 min, each additional 30 min | $71.38 | $72.78 |
90845 | Psychoanalysis | $106.92 | $99.30 |
90846 | Family psychotherapy (without the patient present), 50 minutes | $106.55 | $98.66 |
90847 | Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes | $111.65 | $102.86 |
90849 | Multiple-family group psychotherapy | $41.09 | $37.52 |
90853 | Group psychotherapy (other than of a multiple-family group) | $27.63 | $28.14 |
99201 | Evaluation and Management Services, Outpatient, New Patient | Not covered | Not covered |
99202 | Evaluation and Management Services, Outpatient, New Patient | $71.06 | $69.87 |
99203 | Evaluation and Management Services, Outpatient, New Patient | $109.69 | $109.01 |
99204 | Evaluation and Management Services, Outpatient, New Patient | $164.38 | $163.35 |
99205 | Evaluation and Management Services, Outpatient, New Patient | $216.77 | $215.75 |
99211 | Evaluation and Management Services, Outpatient, Established Patient | $22.92 | $22.64 |
99212 | Evaluation and Management Services, Outpatient, Established Patient | $55.67 | $54.99 |
99213 | Evaluation and Management Services, Outpatient, Established Patient | $89.39 | $88.95 |
99214 | Evaluation and Management Services, Outpatient, Established Patient | $126.07 | $125.18 |
99215 | Evaluation and Management Services, Outpatient, Established Patient | $177.47 | $175.64 |
99354 | Prolonged Services | Not covered | Not covered |
99355 | Prolong Services with E/M | Not covered | Not covered |
96105 | Assessment of aphasia and cognitive performance | $94.30 | $93.80 |
96112 | Developmental testing administration by a physician or qualified health care professional, 1st hr | $121.81 | $127.12 |
96113 | Developmental testing administration by a physician or qualified health care professional, each additional hour | $58.94 | $53.37 |
96116 | Neurobehavioral status exam performed by a physician or qualified health professional, first hour | $90.37 | $88.63 |
96121 | Neurobehavioral status exam performed by a physician or qualified health professional, additional hour | $73.67 | $72.78 |
96125 | Standardized cognitive performance test administered by health care professional | $100.53 | $99.63 |
96127 | Brief emotional and behavioral assessment | $4.58 | $4.53 |
96130 | Psychological testing and evaluation by a physician or qualified health care professional, first hour | $117.88 | $117.42 |
96131 | Psychological testing and evaluation by a physician or qualified health care professional, each additional hour | $84.15 | $82.81 |
96132 | Neuropsychological testing and evaluation by a physician or qualified health care professional, first hour | $126.07 | $125.18 |
96133 | Neuropsychological testing and evaluation by a physician or qualified health care professional, each additional hour | $95.61 | $93.48 |
96136 | Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, first hour | $40.93 | $40.76 |
96137 | Neuropsychological or psychological test administration and scoring by a physician or qualified health care professional, each additional hour | $37.00 | $35.90 |
96138 | Neuropsychological or psychological test administration and scoring by a technician, first hour | $33.73 | $33.64 |
96139 | Neuropsychological or psychological test administration and scoring by a technician, each additional hour | $34.71 | $33.64 |
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