PNP PMHNP Reimbursement Rates by CPT Code [2026]
Individual Psychotherapy Reimbursement Rates for PsyD / PhD in 2026
This is our guide on PNP PMHNP (Psychiatric-Mental Health Nurse Practitioner) reimbursement rates for therapy in 2026. We have rate information for you from a variety of sources. This is not a guarantee of a contracted rate and your rates will depend on you and the insurance company as your time of credentialing. This also does not specify credentials necessary and if you are allowed to bill a specific session.
Rates are not the same as other mental health providers. Rates are not capped at a percentage of the current Medicare reimbursement rate for providers and use the full 100% Medicare Rate as the base rate. For other credentials such as LMFT/LMHC Medicare pays significantly less. If you have a LMFT or LMHC check out our post on LMHC & LMFT & LPC Reimbursement Rates for 2026. PsyD and PhD are also classified differently although the reimbursement rate is typically the same as PNP and PMHNP. Read our guide on PsyD / PhD Reimbursement rates. Note these rates also differ from private insurance which generally pays significantly more.
LMFT and LMHC Reimbursement Rates for Couples and Family Therapy
Please note: these rates are national payment rates and your own locality will have an impact on your county’s or region’s rate. Please see our guide for Medicare reimbursement rates by State if you’re interested in seeing how your State or county pay out.
If all of this sounds too difficult to navigate, consider trying our mental health insurance billing service. We take care of all the frustrating and annoying parts of Medicare billing like enrollment for you as well as figuring out your PNP / PMHNP reimbursement rates for therapy.
If you’d rather bill Medicare on your own, read on.
2026 Reimbursement Rates for PNP PMPHNP (Medicare)
| CPT Code | Description | Medicare Reimbursement Rates LICSW, PsyD, PhDs 2026 | Medicare Reimbursement Rates for LPC, LMFT, LMHC in 2026 |
|---|---|---|---|
| 90791 | Psychological Diagnostic Evaluation | $173.35 | $130.01 |
| 90792 | Psychological Diagnostic Evaluation with Medication Management | $202.08 | $151.56 |
| 90832 | Individual Psychotherapy, 30 Minutes | $85.84 | $64.38 |
| 90833 | Individual Psychotherapy with Evaluation and Management Services, 30 minutes | $81.50 | $61.13 |
| 90834 | Individual Psychotherapy, 45 Minutes | $113.90 | $85.43 |
| 90836 | Individual Psychotherapy with Evaluation and Management Services, 45 minutes | $103.21 | $77.41 |
| 90837 | Individual Psychotherapy, 60 Minutes | $167.00 | $125.25 |
| 90838 | Individual Psychotherapy with Evaluation and Management Services, 60 minutes | $136.61 | $102.46 |
| 90839 | Individual Crisis Psychotherapy initial 60 min | $160.32 | $120.24 |
| 90840 | Individual Crisis Psychotherapy initial 60 min, each additional 30 min | $77.16 | $57.87 |
| 90845 | Psychoanalysis | $109.22 | $81.92 |
| 90846 | Family psychotherapy (without the patient present), 50 minutes | $105.88 | $79.41 |
| 90847 | Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes | $109.55 | $82.16 |
| 90849 | Multiple-family group psychotherapy | $40.42 | $30.32 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | $30.39 | $22.79 |
Colorado Medicaid Reimbursement Rates for PNP PMHNP in 2025
This is included to be another data point to showcase Medicaid reimbursement rates, rates will have increased in 2026.
| Code | Description | LCSW, LICSW, PsyD, PhD Medicaid Reimbursement Rate 2025 | LPC, LMFT, LMHC Medicaid Reimbursement Rate 2025 |
|---|---|---|---|
| 90785 | Interactive complexity (List separately in addition to the code for primary procedure) | $6.20 | $5.14 |
| 90791 | Psychiatric Diagnostic Evaluation without Medical Services | $131.16 | $104.92 |
| 90832 | Psychotherapy 30 Min. | $61.63 | $48.96 |
| 90834 | Psychotherapy 45 Min. | $109.04 | $83.93 |
| 90837 | Psychotherapy 60 Min. | $131.16 | $104.92 |
| 90839 | Psychotherapy for crisis first 60 min. | $150.12 | $130.09 |
| 90839 w/ ET | Crisis Intervention Services - 1st Hour of Response | $214.04 | $189.47 |
| 90840 | Psychotherapy crisis each additional 30 min | $6.32 | $5.25 |
| 90846 | Family Psychotherapy without patient present | $131.16 | $104.92 |
| 90847 | Family/Couple Psychotherapy | $131.16 | $104.92 |
| 90849 | Multiple-family Group Psychotherapy | $63.21 | $54.56 |
| 90853 | Group Psychotherapy | $63.21 | $54.56 |
| 90875 | Biofeedback | $67.79 | $53.86 |
| 90876 | Biofeedback | $119.94 | $92.33 |
| 96116 | Psychological Testing | $132.74 | $0.00 |
| 96121 | Psychological Testing | $132.74 | $0.00 |
| 96130 | Psychological Testing | $132.74 | $106.18 |
| 96131 | Psychological Testing | $132.74 | $106.18 |
| 96132 | Psychological Testing | $132.74 | $106.18 |
| 96133 | Psychological Testing | $132.74 | $106.18 |
| 96136 | Psychological Testing | $132.74 | $106.18 |
| 96137 | Psychological Testing | $66.37 | $53.09 |
| 96138 | Psychological Testing | $66.37 | $53.09 |
| 96139 | Psychological Testing | $66.37 | $53.09 |
| 96146 | Psychological Testing | $132.74 | $106.18 |
| 97535 | Self-care/home management training (e.g. activities of daily living and compensatory training | $20.21 | $17.89 |
| 97537 | Community/work reintegration training (e.g. shopping | $20.21 | $17.89 |
| H0001 | Alcohol and/or Drug (AOD) Assessment | $158.02 | $104.92 |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | $11.06 | $9.79 |
| H0004 | Behavioral Health Counseling And Therapy Per 15 Minutes | $23.70 | $15.74 |
| H0005 | Alcohol and/or drug services; group counseling | $48.99 | $33.57 |
| H0006 | Alcohol and/or drug services; case management | $17.38 | $15.39 |
| H0020 | Alcohol And/or Drug Services; Methadone Administration And/or Service (Provision Of The Drug By A Licensed Program) | $16.30 | $14.43 |
| H0023 | Drop-in center | $10.10 | $8.94 |
| H0025 | Behavioral health prevention education service (delivery of services to affect knowledge attitude and/or behavior) | $60.31 | $44.96 |
| H0029 | Alcohol and/or drug prevention alternatives service (services for populations that exclude alcohol and other drug use e.g. alcohol-free social events) | $40.42 | $35.78 |
| H0032 | Mental health service plan development by non-physician | $73.85 | $55.05 |
| H0034 | Medication training and support per 15 mins | $20.21 | $17.89 |
| H0036 | Functional Family Therapy | $49.35 | $43.68 |
| H0037 | Community psychiatric support treatment per diem | $1 | 183.89 |
| H0038 | RSSO CODE | $20.21 | $17.89 |
| H0043 | Supported housing per diem | $26.94 | $23.85 |
| H0044 | Supported housing per month | $808.30 | $715.53 |
| H2011 | Crisis Intervention Service Per 15 Minutes | $26.75 | $23.68 |
| H2011 w/ET | Crisis Intervention Services Each Additional 15 Minutes / Follow Up | $20.21 | $17.89 |
| H2012 | Day treatment per hour | $150.12 | $130.09 |
| H2014 | Skills training and development per 15 mins | $21.34 | $18.89 |
| H2015 | Comprehensive community support services per 15 minutes | $22.65 | $20.05 |
| H2017 | Psychosocial rehab services per 15 mins | $20.21 | $17.89 |
| H2018 | Psychosocial rehab services per diem | $242.49 | $214.66 |
| H2021 | Community-based wrap-around services per 15 minutes | $20.21 | $17.89 |
| H2022 | Community based wrap services per diem | $297.93 | $263.73 |
| H2023 | Supported employment per 15 mins | $20.21 | $17.89 |
| H2025 | Ongoing support to maintain employment per 15 mins | $20.21 | $17.89 |
| H2026 | Ongoing support to maintain employment per diem | $242.49 | $214.66 |
| H2027 | Psychoeducational service per 15 minutes | $20.21 | $17.89 |
| H2032 | Activity therapy per 15 minutes | $20.21 | $17.89 |
| H2033 | Multi-Systemic Therapy | $51.49 | $45.58 |
| S9445 | Patient education not otherwise classified | $19.77 | $17.50 |
| T1012 | Alcohol and/or substance abuse services skills development | $20.21 | $17.89 |
| T1017 | Targeted case management each 15 minutes | $20.21 | $17.89 |
Sources:
- https://www.cms.gov/files/document/marriage-and-family-therapists-and-mental-health-counselors-faq.pdf
- https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/marriage-and-family-therapists-mental-health-counselors
- https://www.cms.gov/medicare/physician-fee-schedule/search
- https://www.uhcprovider.com/content/dam/provider/docs/public/commplan/co/behavior-health/CO-Value-based-fee-schedule-2025.pdf
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