California Reimbursement Rates for Therapy and Mental Health Providers [2022]

CA Therapy Reimbursement RatesEnjoy learning about California mental health insurance reimbursement rates for therapy and mental health providers in 2022!  Our goal with this article is to educate behavioral health providers in CA about the insurance companies and payment amounts for psychotherapy by insurance company and county or locality.

California Reimbursement Rates: Commercial Insurance Companies

Below you’ll find reimbursement rates for common commercial insurance policies, as well as the chart below.

Please note: these rates depend on your license level, your negotiated rate, and CPT codes used.  These rates are not guaranteed, nor are we able to post actual values to ensure we do not misrepresent rates set by these insurance companies.

With those clarifications aside, please see estimated mental health reimbursement rates for mental health providers in California:

california reimbursement rates for therapy

Insurance CompanyComparison Against Average Reimbursement in CA
Medicare131.52%
Kaiser Permanente116.30%
Aetna102.17%
Anthem Blue Cross96.74%
TriCare West92.39%
United Health Care88.04%
Beacon Health Options86.96%
Cigna84.78%
Medi-Cal70.65%
Blue Shield MHSA70.65%
Molina59.78%

CA Medicare Reimbursement Rates by Locality:

You’ll note that Medicare does adjust reimbursement rates based on county and locality.  These are 2022 Medicare reimbursement rates for CPT Code 90791 – Diagnostic Interview.

CA County / LocalityCPT Code 90791 Reimbursement Rate 2022Reimbursement Compared to National Rate
NATIONAL$195.46100.00%
SANTA CLARA (SANTA CLARA COUNTY)$224.26114.73%
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO COUNTY)$225.09115.16%
SAN FRANCISCO (SAN FRANCISCO COUNTY)$219.23112.16%
SAN MATEO (SAN MATEO COUNTY)$219.23112.16%
OAKLAND-BERKLEY (ALAMEDA AND CONTRA COSTA)$219.23112.16%
SAN FRANCISCO-OAKLAND-HAYWARD (MARIN COUNTY)$219.44112.27%
SALINAS (MONTEREY COUNTY)$209.01106.93%
NAPA$209.67107.27%
VALLEJO-FAIRFIELD (SOLANO COUNTY)$209.67107.27%
SANTA CRUZ-WATSONVILLE$209.55107.21%
SANTA ROSA (SONOMA COUNTY)$208.27106.55%
RIVERSIDE-SAN BERNARDINO-ONTARIO (SAN BERNARDINO AND RIVERSIDE COUNTY)$202.15103.42%
BAKERSFIELD (KERN COUNTY)$202.42103.56%
SACRAMENTO-ROSEVILLE-ARDEN-ARCADE (SACRAMENTO, PLACER, YOLO, EL DORADO)$202.86103.79%
CHICO (BUTTE COUNTY)$200.53102.59%
FRESNO$200.53102.59%
HANFORD-CORCORAN (KINGS COUNTY)$200.53102.59%
MADERA$200.53102.59%
MERCED$200.53102.59%
MODESTO (STANISLAUS COUNTY)$200.53102.59%
REDDING (SHASTA COUNTY)$200.53102.59%
STOCKTON-LODI (SAN JOAQUIN COUNTY)$200.53102.59%
VISALIA-PORTERVILLE (TULARE COUNTY)$200.53102.59%
YUBA CITY (SUTTER, YUBA)$200.53102.59%
CALIFORNIA (ALL OTHER COUNTIES)$200.53102.59%
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES COUNTY)$209.34107.10%
LONG BEACH-ANAHEIM (ORANGE COUNTY)$209.34107.10%
OXNARD-THOUSAND OAKS-VENTURA$206.33105.56%
SANTA MARIA-SANTA BARBARA$207.59106.21%
SAN DIEGO-CARLSBAD$206.43105.61%
SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE$201.63103.16%
EL CENTRO (IMPERIAL COUNTY)$200.63102.65%

(Source)

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