RxDoctor Payments Data

CPT 90853

Group psychotherapy

$23.01Medicare-allowed amount per service, averaged across 225,828 services
Providers submitted
$84.35

Asking price, not received

Medicare allowed
$23.01

The fee schedule figure

Medicare paid
$17.68

Balance is patient coinsurance

Providers submitted an average of $84.35 for this code and Medicare allowed $23.013.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $17.68 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$23.28
Hospital / facility
$22.05

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 175,993 services were billed in an office setting and 49,835 in a facility.

Services
225,828

Medicare Part B, 2024

Beneficiaries
18,533
Providers billing it
773
Total allowed
$5,196,302

Services × allowed amount

What Medicare pays for CPT 90853

Across 225,828 services billed by 773 providers to 18,533 beneficiaries, Medicare allowed an average of $23.01 per service. That is 12.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 90853

SpecialtyServicesBeneficiariesAvg allowedProviders
Licensed Clinical Social Worker96,6706,593$20.43325
Psychologist, Clinical60,5967,233$26.42244
Psychiatry29,3441,773$26.7673
Licensed Professional Counselor22,1601,531$20.2373
Nurse Practitioner13,333785$22.3330
Marriage and Family Therapist1,576350$20.3718
Emergency Medicine39032$26.361
Gastroenterology37313$28.651
Nephrology335100$24.342
Anesthesiology28717$26.091
Addiction Medicine23533$25.161
Physician Assistant22230$24.632
Neurology18522$27.291
Hematology-Oncology12221$29.041

90853 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Texas32,179$22.60$17.3729
California20,364$25.75$18.1391
New York20,043$24.50$17.2167
Illinois18,057$24.85$19.2418
Georgia16,063$20.53$16.1022
Massachusetts12,422$24.76$17.7268
Michigan12,371$20.92$16.1132
Florida12,182$24.37$18.6818
Arkansas10,909$21.17$16.6733
Connecticut9,817$20.30$14.6465
Missouri5,691$18.67$14.7525
Maryland5,625$22.28$16.3731
Pennsylvania5,588$24.21$18.0931
New Jersey4,799$23.36$16.7623
Nevada4,109$25.75$20.723
Virginia4,028$21.04$17.4311
Minnesota3,224$22.02$17.0320
Arizona3,086$23.17$18.239
Ohio2,992$21.69$16.7028
North Carolina2,519$20.30$14.7117
Indiana1,987$22.02$17.1314
New Hampshire1,943$24.04$19.0016
Alabama1,902$22.13$17.393
Wisconsin1,544$24.59$19.0514
Alaska1,305$30.15$17.043
Vermont1,114$20.10$15.567
South Dakota807$26.30$19.402
Delaware796$21.13$15.701
Montana708$19.15$15.113
Mississippi681$21.27$17.413
Iowa641$22.08$17.224
Washington630$22.59$14.278
Kentucky624$20.54$16.526
District of Columbia541$27.14$17.593
Louisiana493$23.57$18.464
West Virginia489$21.13$14.966
Kansas489$19.68$15.672
Maine485$20.17$16.055
Puerto Rico472$25.81$19.892
Utah402$21.44$16.644
Colorado374$22.19$16.626
Oregon310$21.09$16.313
North Dakota251$22.57$18.223
Wyoming224$20.94$15.103
Nebraska199$21.28$17.432
Tennessee173$22.73$17.362
Oklahoma93$22.82$17.752
Rhode Island83$18.10$13.081

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.