The Same Hour of Therapy Pays $52 in Pennsylvania and $324 in Alaska

90837 is the therapy hour: an extended individual psychotherapy session, the code a full-length appointment usually bills. The session is the same everywhere. What Medicaid pays for it is not. Pennsylvania publishes $52.00 for a 90837. Alaska publishes $323.68. That is a 6.2x gap, wider than the spread we found for the routine office visit (though the dental filling still holds the record), and mental health is where the gaps carry the most policy weight.

Across the 48 states publishing a comparable rate, the median is $133, about 80% of the $167 Medicare pays for the same session on the 2026 national schedule. Five states pay above Medicare: Alaska (194% of the Medicare amount), Montana (130%), North Dakota (112%), Virginia (102%), and Arizona (101%), with Arkansas at parity. At the bottom, Pennsylvania (31%), Illinois (41%), Iowa and New Jersey (50%), and Alabama (51%) all pay half the Medicare rate or less.

Finding the rate is the hard part

Behavioral health is Medicaid's most carved-out category, which means the number you need is often not where you expect. Maryland's therapy rates are not published by its Medicaid agency at all: mental health runs fee-for-service through the state's Public Behavioral Health System, and the schedules live with its administrator, published by clinician credential. Pennsylvania's $52 is its published fee-for-service rate, but most Pennsylvania Medicaid behavioral care actually flows through county-based managed care whose negotiated rates are not published, so the state schedule reads more like a floor than a market price. Tennessee publishes nothing for the code, because TennCare runs entirely through managed-care plans whose contracts are private. Same code, three completely different answers to "where do I even look?"

The same hour, a different rate by credential

The second thing hiding in these schedules: many states do not pay one rate for a 90837 at all. Maryland's published ladder for the identical session runs from $144.14 at an outpatient mental health center and $141.31 for a psychiatrist down to $115.12 for a psychologist and $101.07 for licensed clinical social workers and counselors, a 43% spread decided entirely by who is sitting in the therapist's chair. About a dozen states publish credential ladders like this on standard codes; we lay them side by side on the therapy-rates-by-credential page. Most other states publish one rate and leave the credential economics to managed-care contracts.

Look up your own state

Every number above comes from the states' published schedules, collected wherever they actually live: state Medicaid sites, behavioral health administrators, and carve-out portals. You can compare all 48 states on this exact session, browse every state's behavioral health schedule, read how Maryland's carve-out works, or start from your own state's hub via the category index. The complete all-codes schedules, with CSV export and rate-change tracking, come with the $29/mo Rates plan.

Methodology: rates queried from the ProviderSignal fee-schedule database on August 24, 2026. Per-state figure = the state's benchmark fee-for-service rate for CPT 90837 (its standard published schedule where one exists; Maryland's comes from its Public Behavioral Health System schedules, shown at the highest published professional tier). Medicare comparator = the 2026 national non-facility Physician Fee Schedule amount ($167). 48 of 51 jurisdictions publish a comparable rate: Tennessee publishes no medical FFS schedule, and Nebraska and South Dakota do not publish a bare rate for this code in the schedules we collect. These are fee-for-service schedule amounts, not managed-care plan rates, and rates shift as states publish updates.