`90838` Psytx w pt w e/m 60 min

What 90838 is

CMS fee schedule short descriptor: Psytx w pt w e/m 60 min.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 90838 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	2.86	1.11	0.12	4.09	$136.61
Facility (hospital, ASC)	2.86	0.32	0.12	3.30	$110.22

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.

Medically Unlikely Edit (MUE)

Medicare caps 90838 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 90838? These codes are bundled into it

90838 is a Column 1 code in 170 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`0362T`	Bhv id suprt assmt ea 15 min	0 - no modifier bypass	Check pair
`0373T`	Adapt bhv tx ea 15 min	0 - no modifier bypass	Check pair
`0591T`	Hlth&wb coaching indiv 1st	0 - no modifier bypass	Check pair
`0592T`	Hlth&wb coaching indiv f-up	0 - no modifier bypass	Check pair
`0593T`	Hlth&wb coaching group	0 - no modifier bypass	Check pair
`0776T`	Ther indctj ntrabrn hypthrm	0 - no modifier bypass	Check pair
`0820T`	Mntr psychdlc med 1stphy/qhp	0 - no modifier bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`36640`	Insertion catheter artery	1 - modifier may bypass	Check pair
`90832`	Psytx w pt 30 minutes	0 - no modifier bypass	Check pair
`90833`	Psytx w pt w e/m 30 min	0 - no modifier bypass	Check pair
`90834`	Psytx w pt 45 minutes	0 - no modifier bypass	Check pair
`90836`	Psytx w pt w e/m 45 min	0 - no modifier bypass	Check pair
`90837`	Psytx w pt 60 minutes	0 - no modifier bypass	Check pair
`90839`	Psytx crisis initial 60 min	0 - no modifier bypass	Check pair
`90840`	Psytx crisis ea addl 30 min	0 - no modifier bypass	Check pair
`90845`	Psychoanalysis	0 - no modifier bypass	Check pair
`90867`	Tcranial magn stim tx plan	1 - modifier may bypass	Check pair
`90868`	Tcranial magn stim tx deli	1 - modifier may bypass	Check pair
`90869`	Tcran magn stim redetemine	1 - modifier may bypass	Check pair
`90875`	Psychophysiological therapy	0 - no modifier bypass	Check pair
`90876`	Psychophysiological therapy	0 - no modifier bypass	Check pair
`96116`	Nubhvl xm phys/qhp 1st hr	1 - modifier may bypass	Check pair
`96127`	Brief emotional/behav assmt	0 - no modifier bypass	Check pair
`96156`	Hlth bhv assmt/reassessment	0 - no modifier bypass	Check pair
`96158`	Hlth bhv ivntj indiv 1st 30	0 - no modifier bypass	Check pair
`96159`	Hlth bhv ivntj indiv ea addl	0 - no modifier bypass	Check pair
`96160`	Pt-focused hlth risk assmt	0 - no modifier bypass	Check pair
`96161`	Caregiver health risk assmt	0 - no modifier bypass	Check pair

Showing 30 of 170 column 2 codes. Use the pair checker for any specific combination.

90838 is bundled into these codes

90838 appears as a Column 2 code in 85 active edits. Reported with one of these Column 1 codes on the same date of service, 90838 is the code that denies.

Column 1 code	Short description
`0395T`	Hdr elctr ntrst/ntrcv brchtx	Check pair
`77261`	Ther radiology tx plng smpl	Check pair
`77262`	Ther radiology tx plng intrm	Check pair
`77263`	Ther radiology tx plng cplx	Check pair
`77280`	Ther rad simulaj field smpl	Check pair
`77285`	Ther rad simulaj field intrm	Check pair
`77290`	Ther rad simulaj field cplx	Check pair
`77293`	Respirator motion mgmt simul	Check pair
`77295`	3-d radiotherapy plan	Check pair
`77300`	Radiation therapy dose plan	Check pair
`77301`	Radiotherapy dose plan imrt	Check pair
`77306`	Telethx isodose plan simple	Check pair
`77307`	Telethx isodose plan cplx	Check pair
`77316`	Brachytx isodose plan simple	Check pair
`77317`	Brachytx isodose intermed	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.