Medicare Reimbursement for Mental Health Therapy by State [2024]
Enjoy learning about the comparative difference in Medicare Reimbursement Rates for Therapy by State. You’ll learn how Medicare divides each state and territory by locality, what Medicare pays for CPT Code 90791, and which localities pay the most.
The data below represents Medicare 2024 reimbursement rates for a diagnostic interview by a licensed mental health professional. Reimbursement rates depend on license level, professional vs facility services, and payment modifiers that may or may not apply.
| State | Fee Schedule Area | CPT Code 90791 Reimbursement Rate | Reimbursement Compared to National Rate |
|---|---|---|---|
| NATIONAL | NATIONAL | $195.46 | 100.00% |
| CA - California | SANTA CLARA (SANTA CLARA COUNTY) | $224.26 | 114.73% |
| CA - California | SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO COUNTY) | $225.09 | 115.16% |
| CA - California | SAN FRANCISCO (SAN FRANCISCO COUNTY) | $219.23 | 112.16% |
| CA - California | SAN MATEO (SAN MATEO COUNTY) | $219.23 | 112.16% |
| CA - California | OAKLAND-BERKLEY (ALAMEDA AND CONTRA COSTA) | $219.23 | 112.16% |
| CA - California | SAN FRANCISCO-OAKLAND-HAYWARD (MARIN COUNTY) | $219.44 | 112.27% |
| CA - California | SALINAS (MONTEREY COUNTY) | $209.01 | 106.93% |
| CA - California | NAPA | $209.67 | 107.27% |
| CA - California | VALLEJO-FAIRFIELD (SOLANO COUNTY) | $209.67 | 107.27% |
| CA - California | SANTA CRUZ-WATSONVILLE | $209.55 | 107.21% |
| CA - California | SANTA ROSA (SONOMA COUNTY) | $208.27 | 106.55% |
| CA - California | RIVERSIDE-SAN BERNARDINO-ONTARIO (SAN BERNARDINO AND RIVERSIDE COUNTY) | $202.15 | 103.42% |
| CA - California | BAKERSFIELD (KERN COUNTY) | $202.42 | 103.56% |
| CA - California | SACRAMENTO-ROSEVILLE-ARDEN-ARCADE (SACRAMENTO, PLACER, YOLO, EL DORADO) | $202.86 | 103.79% |
| CA - California | CHICO (BUTTE COUNTY) | $200.53 | 102.59% |
| CA - California | FRESNO | $200.53 | 102.59% |
| CA - California | HANFORD-CORCORAN (KINGS COUNTY) | $200.53 | 102.59% |
| CA - California | MADERA | $200.53 | 102.59% |
| CA - California | MERCED | $200.53 | 102.59% |
| CA - California | MODESTO (STANISLAUS COUNTY) | $200.53 | 102.59% |
| CA - California | REDDING (SHASTA COUNTY) | $200.53 | 102.59% |
| CA - California | STOCKTON-LODI (SAN JOAQUIN COUNTY) | $200.53 | 102.59% |
| CA - California | VISALIA-PORTERVILLE (TULARE COUNTY) | $200.53 | 102.59% |
| CA - California | YUBA CITY (SUTTER, YUBA) | $200.53 | 102.59% |
| CA - California | CALIFORNIA (ALL OTHER COUNTIES) | $200.53 | 102.59% |
| CA - California | LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES COUNTY) | $209.34 | 107.10% |
| CA - California | LONG BEACH-ANAHEIM (ORANGE COUNTY) | $209.34 | 107.10% |
| CA - California | OXNARD-THOUSAND OAKS-VENTURA | $206.33 | 105.56% |
| CA - California | SANTA MARIA-SANTA BARBARA | $207.59 | 106.21% |
| CA - California | SAN DIEGO-CARLSBAD | $206.43 | 105.61% |
| CA - California | SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE | $201.63 | 103.16% |
| CA - California | EL CENTRO (IMPERIAL COUNTY) | $200.63 | 102.65% |
| HI - Hawaii | HAWAII, GUAM, AMERICAN SAMOA, MARSHALL ISLANDS, PALAU, NORTHERN MARIANA ISLANDS, FEDERATED STATES OF MICRONESIA | $201.98 | 103.34% |
| NV - Nevada | STATEWIDE | $197.78 | 101.19% |
| AK - Alaska | STATEWIDE | $271.70 | 139.01% |
| ID - Idaho | STATEWIDE | $187.19 | 95.77% |
| OR - Oregon | PORTLAND (CLACKAMAS, MULTNOMAH AND WASHINGTON) | $199.43 | 102.03% |
| OR - Oregon | REST OF STATE | $190.93 | 97.68% |
| WA - Washington | WASHINGTON SEATTLE (KING COUNTY) | $208.55 | 106.70% |
| WA - Washington | REST OF STATE | $194.94 | 99.73% |
| AZ - Arizona | STATEWIDE | $192.57 | 98.52% |
| MT - Montana | STATEWIDE | $195.36 | 99.95% |
| ND - North Dakota | STATEWIDE | $192.88 | 98.68% |
| SD - South Dakota | STATEWIDE | $192.50 | 98.49% |
| UT - Utah | STATEWIDE | $190.85 | 97.64% |
| WY - Wyoming | STATEWIDE | $194.74 | 99.63% |
| CO - Colorado | STATEWIDE | $196.70 | 100.63% |
| NM - New Mexico | STATEWIDE | $191.46 | 97.95% |
| OK - Oklahoma | STATEWIDE | $189.03 | 96.71% |
| TX - Texas | HOUSTON | $200.98 | 102.82% |
| TX - Texas | GALVESTON (TARRANT COUNTY) | $199.26 | 101.94% |
| TX - Texas | BRAZORIA | $199.12 | 101.87% |
| TX - Texas | DALLAS | $197.93 | 101.26% |
| TX - Texas | FORT WORTH (TARRANT COUNTY) | $195.47 | 100.01% |
| TX - Texas | AUSTIN (TRAVIS COUNTY) | $196.07 | 100.31% |
| TX - Texas | REST OF STATE | $191.52 | 97.98% |
| TX - Texas | BEAUMONT (JEFFERSON COUNTY) | $190.86 | 97.65% |
| IA - Iowa | STATEWIDE | $188.60 | 96.49% |
| KS - Kansas | STATEWIDE | $188.80 | 96.59% |
| MO - Missouri | METROPOLITAN ST. LOUIS (JEFFERSON, ST. CHARLES, ST. LOUIS AND ST. LOUIS CITY) | $193.86 | 99.18% |
| MO - Missouri | METROPOLITAN KANSAS CITY (CLAY, JACKSON AND PLATTE) | $192.91 | 98.70% |
| MO - Missouri | REST OF STATE | $187.91 | 96.14% |
| NE - Nebraska | STATEWIDE | $187.78 | 96.07% |
| IL - Illinois | CHICAGO (COOK COUNTY) | $203.03 | 103.87% |
| IL - Illinois | SUBURBAN CHICAGO (DUPAGE, KANE, LAKE AND WILL) | $201.46 | 103.07% |
| IL - Illinois | EAST ST. LOUIS (BOND, CALHOUN, CLINTON, JERSEY, MACOUPIN, MADISON, MONROE, MONTGOMERY, RANDOLPH, ST. CLAIR AND WASHINGTON) | $195.81 | 100.18% |
| IL - Illinois | REST OF STATE | $192.26 | 98.36% |
| MN - Minnesota | STATEWIDE | $193.12 | 98.80% |
| WI - Wisconsin | STATEWIDE | $189.62 | 97.01% |
| AR - Arkansas | STATEWIDE | $186.04 | 95.18% |
| LA - Louisiana | NEW ORLEANS (JEFFERSON, ORLEANS, PLAQUEMINES AND ST. BERNARD) | $194.52 | 99.52% |
| LA - Louisiana | REST OF STATE | $191.00 | 97.72% |
| MS - Mississippi | STATEWIDE | $186.74 | 95.54% |
| IN - Indiana | STATEWIDE | $188.46 | 96.42% |
| MI - Michigan | DETROIT (MACOMB, OAKLAND, WASHTENAW AND WAYNE) | $198.15 | 101.38% |
| MI - Michigan | REST OF STATE | $191.30 | 97.87% |
| FL - Florida | MIAMI (DADE AND MONROE COUNTY) | $203.91 | 104.32% |
| FL - Florida | FORT LAUDERDALE (BROWARD, COLLIER, INDIAN RIVER, LEE, MARTIN, PALM BEACH, AND ST. LUCIE) | $199.41 | 102.02% |
| FL - Florida | REST OF STATE | $194.65 | 99.59% |
| PR - Puerto Rico | PUERTO RICO | $195.77 | 100.16% |
| VI - Virgin Islands | VIRGIN ISLANDS | $195.77 | 100.16% |
| AL - Alabama | STATEWIDE | $189.98 | 97.20% |
| GA - Georgia | ATLANTA (BUTTS, CHEROKEE, CLAYTON, COBB, DEKALB, DOUGLAS, FAYETTE, FORSYTH, FULTON, GWINNETT, NEWTON, ROCKDALE AND WALTON) | $194.94 | 99.73% |
| GA - Georgia | REST OF STATE | $189.45 | 96.93% |
| TN - Tennessee | STATEWIDE | $188.22 | 96.30% |
| SC - South Carolina | STATEWIDE | $189.64 | 97.02% |
| VA - Virginia | STATEWIDE | $194.77 | 99.65% |
| WV - West Virginia | STATEWIDE | $189.87 | 97.14% |
| NC - North Carolina | STATEWIDE | $191.35 | 97.90% |
| DE - Delaware | STATEWIDE | $196.87 | 100.72% |
| DC - Washington, DC | DC + MD/VA SUBURBS (DISTRICT OF COLUMBIA; ALEXANDRIA CITY, ARLINGTON, FAIRFAX, FAIRFAX CITY, FALLS CHURCH CITY IN VIRGINIA; MONTGOMERY AND PRINCE GEORGE'S IN MARYLAND) | $215.43 | 110.22% |
| MD - Maryland | BALTIMORE/SURROUNDING COUNTIES | $205.34 | 105.05% |
| MD - Maryland | REST OF STATE | $199.07 | 101.85% |
| NJ - New Jersey | NORTHERN NEW JERSEY (BERGEN, ESSEX, HUDSON, HUNTERDON, MIDDLESEX, MORRIS, PASSAIC, SOMERSET, SUSSEX, UNION AND WARREN) | $211.50 | 108.21% |
| NJ - New Jersey | REST OF STATE | $207.10 | 105.96% |
| PA - Pennsylvania | METROPOLITAN PHILADELPHIA (BUCKS, CHESTER, DELAWARE, MONTGOMERY AND PHILADELPHIA) | $203.36 | 104.04% |
| PA - Pennsylvania | REST OF STATE | $192.17 | 98.32% |
| CT - Connecticut | STATEWIDE | $205.75 | 105.26% |
| NY - New York | NYC SUBURBS/LONG ISLAND (BRONX, KINGS, NASSAU, RICHMOND, ROCKLAND, SUFFOLK AND WESTCHESTER) | $220.07 | 112.59% |
| NY - New York | MANHATTAN | $217.56 | 111.31% |
| NY - New York | POUGHKPSIE/N NYC SUBURBS (COLUMBIA, DELAWARE, DUTCHESS, GREENE, ORANGE, PUTNAM, SULLIVAN AND ULSTER) | $207.12 | 105.97% |
| NY - New York | REST OF STATE | $192.28 | 98.37% |
| NY - New York | QUEENS | $221.56 | 113.35% |
| ME - Maine | SOUTHERN MAINE (CUMBERLAND AND YORK COUNTY) | $193.75 | 99.13% |
| ME - Maine | REST OF STATE | $189.22 | 96.81% |
| MA - Massachusetts | METROPOLITAN BOSTON (MIDDLESEX, NORFOLK AND SUFFOLK) | $211.15 | 108.03% |
| MA - Massachusetts | REST OF STATE | $201.31 | 102.99% |
| NH - New Hampshire | STATEWIDE | $196.83 | 100.70% |
| RI - Rhode Island | STATEWIDE | $200.62 | 102.64% |
| VT - Vermont | STATEWIDE | $193.55 | 99.02% |
| KY - Kentucky | STATEWIDE | $188.69 | 96.54% |
| OH - Ohio | STATEWIDE | $191.91 | 98.18% |
(Source)
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