Current fee-for-service (FFS) rates published by NY State Department of Health for behavioral health codes. ABA therapy and psychotherapy codes, plus the E/M codes CMS requires in the Medicaid-vs-Medicare comparative analysis for outpatient mental health/SUD.
FFS benchmark rates only — managed care organization (MCO) contract rates may differ. Not legal or compliance advice.
| Code | Description | Variant | Rate | Effective | Status |
|---|---|---|---|---|---|
| 90791 | Initial psychiatric diagnostic evaluation without medical services. | Non-Facility | $177.67 / encounter | 2026-07-01 | Auto-extracted |
| Facility | $60.38 / encounter | 2026-07-01 | Auto-extracted | ||
| 90837 | Individual psychotherapy, approximately 60 minutes. | Non-Facility | $161.13 / session (60 min) | 2026-07-01 | Auto-extracted |
| Facility | $57.05 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Non-Facility | $161.13 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Facility | $57.05 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Non-Facility | $161.13 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Facility | $57.05 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Non-Facility | $161.13 / session (60 min) | 2026-07-01 | Auto-extracted | ||
| Facility | $57.05 / session (60 min) | 2026-07-01 | Auto-extracted |
Source: NY State Department of Health
No. These are fee-for-service (FFS) benchmark rates published directly by New York's Medicaid agency. Managed care organizations (MCOs) negotiate their own contract rates separately, and those aren't published publicly — FFS rates are commonly used as a reference point, not a guarantee of what an MCO will pay.
It varies by state and code — some update annually, others quarterly or on an as-needed basis. MedicaidBench checks official sources continuously and logs the effective date and source document for every rate change.
This page shows the codes available on our Free plan. Sign up free to look up any code in any state, or upgrade for full rate history and instant change alerts.
Free for 14 days, no credit card. Get instant alerts the moment a rate you're watching changes.
Start free trial →