How much does Medicare pay for CPT 90868?

Medicare allowed an average of $183.83 per service and paid $145.76 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $578.81, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 90868?

Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management. It was billed 231,177 times to 8,846 Medicare beneficiaries by 386 providers in 2024.

Does 90868 pay differently in an office than a hospital?

Yes. The allowed amount averaged $185.85 in an office setting and $92.28 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 90868 most?

Psychiatry, with 221,153 services from 359 clinicians. Next are Nurse Practitioner, Neurology, Geriatric Psychiatry.

CPT 90868

Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management

$183.83Medicare-allowed amount per service, averaged across 231,177 services

Providers submitted

$578.81

Asking price, not received

Medicare allowed

$183.83

The fee schedule figure

Medicare paid

$145.76

Balance is patient coinsurance

Providers submitted an average of $578.81 for this code and Medicare allowed $183.83 — 3.1× 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 $145.76 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $185.85
Hospital / facility: $92.28

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. 226,195 services were billed in an office setting and 4,982 in a facility.

Services: 231,177
Beneficiaries: 8,846
Providers billing it: 386
Total allowed: $42,497,268

What Medicare pays for CPT 90868

Across 231,177 services billed by 386 providers to 8,846 beneficiaries, Medicare allowed an average of $183.83 per service. That is 26.1 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 90868

Specialty	Services	Beneficiaries	Avg allowed	Providers
Psychiatry	221,153	8,377	$185.41	359
Nurse Practitioner	2,927	185	$131.91	12
Neurology	2,916	109	$133.50	7
Geriatric Psychiatry	1,362	50	$188.91	2
Neuropsychiatry	1,031	24	$206.96	1
Physician Assistant	546	45	$100.53	2
Family Practice	505	13	$217.89	1
Internal Medicine	400	29	$117.76	1
Pain Management	337	14	$109.23	1

90868 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.

State	Services	Allowed	Standardized pmt	Providers
Florida	96,631	$204.33	$162.30	58
California	24,680	$129.85	$103.04	75
New York	11,453	$212.50	$168.67	23
Texas	9,295	$188.10	$151.48	20
Massachusetts	8,980	$215.54	$172.21	24
Washington	8,846	$113.79	$91.75	9
New Jersey	7,456	$207.63	$168.78	15
Illinois	6,339	$209.82	$173.05	13
Pennsylvania	5,980	$193.75	$155.61	13
Maryland	4,707	$204.07	$166.15	10
North Carolina	3,116	$164.65	$132.25	8
Arkansas	2,667	$169.90	$136.12	4
Connecticut	2,587	$217.88	$172.89	5
Kentucky	2,517	$176.43	$143.98	3
Oregon	2,516	$109.17	$86.47	8
Utah	2,441	$77.70	$60.85	4
Nevada	1,966	$115.09	$92.95	5
New Hampshire	1,811	$194.30	$156.92	8
Hawaii	1,767	$129.00	$101.81	2
Colorado	1,765	$193.72	$159.23	5
Georgia	1,752	$167.31	$143.54	3
Nebraska	1,695	$123.87	$105.31	3
Michigan	1,690	$113.74	$95.88	2
Wisconsin	1,639	$205.09	$169.61	3
Virginia	1,559	$166.01	$136.97	4
Minnesota	1,519	$208.82	$174.55	8
South Carolina	1,464	$170.11	$135.28	5
West Virginia	1,416	$171.39	$140.85	4
Ohio	1,201	$195.70	$155.12	3
Kansas	1,201	$139.23	$110.30	3
New Mexico	943	$187.15	$148.69	2
Tennessee	914	$164.64	$134.21	2
Missouri	873	$153.18	$127.80	3
Alabama	826	$154.21	$137.73	2
Montana	696	$104.50	$82.77	2
Oklahoma	590	$187.46	$137.09	1
Mississippi	577	$176.88	$140.26	2
Idaho	520	$104.57	$82.27	2
Indiana	463	$134.60	$112.38	1
Rhode Island	451	$217.91	$171.57	6
Delaware	415	$196.90	$154.65	1
Iowa	400	$87.66	$69.64	5
Alaska	315	$133.98	$106.75	1
South Dakota	272	$108.35	$86.02	5
District of Columbia	266	$236.23	$176.29	1

Related codes

90837Psychotherapy$127.42
90834Psychotherapy$88.04
90832Psychotherapy$65.95
90833Psychotherapy$64.86
90836Psychotherapy$88.70
90853Group psychotherapy$23.01
90870Therapy using electrical currents$103.73
90838Psychotherapy$113.05
90847Family psychotherapy$92.01
90839Psychotherapy for crisis$113.12
90846Family psychotherapy without patient$83.43
90867Treatment using magnetic field to stimulate nerve cells in brain, init$285.49

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.