The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full North Carolina behavioral health schedule has 24 codes.
- Every code on all 51 published schedules
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Published codes
24
Behavioral Health procedures on the 2025 schedule
Median % of Medicare
63.3%
vs national Medicare, GPCI-neutral
Effective vintage
2025
latest effective year on the schedule
Common behavioral health procedures and what North Carolina Medicaid pays
A curated sample of recognizable procedures from the 24-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | North Carolina rate | % of Medicare |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | $121.63 | 70.2% |
| 90792 | Psychiatric diagnostic evaluation with medical services | $101.44 | 50.2% |
| 90832 | Psychotherapy, 30 minutes | $50.67 | 59% |
| 90833 | Psychotherapy, 30 minutes, added to an E&M visit | $33.86 | 41.5% |
| 90834 | Psychotherapy, 45 minutes | $65.81 | 57.8% |
| 90836 | Psychotherapy, 45 minutes, added to an E&M visit | $55.02 | 53.3% |
| 90837 | Psychotherapy, 60 minutes | $96.44 | 57.7% |
| 90838 | Psychotherapy, 60 minutes, added to an E&M visit | $88.84 | 65% |
| 90839 | Psychotherapy for crisis, first 60 minutes | $121.52 | 75.8% |
| 90840 | Psychotherapy for crisis, each added 30 minutes | $102.31 | 132.6% |
| 90846 | Family psychotherapy without the patient, 50 minutes | $71.50 | 67.5% |
| 90847 | Family psychotherapy with the patient, 50 minutes | $88.78 | 81% |
| 90849 | Multiple-family group psychotherapy | $26.63 | 65.9% |
| 90853 | Group psychotherapy | $25.31 | 83.3% |
| 90870 | Electroconvulsive therapy (ECT) | $109.94 | 60.4% |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $19.81 | -- |
| H0031 | Mental health assessment, by non-physician | $19.22 | -- |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.
More North Carolina Medicaid fee schedules
- North Carolina physician fee schedule · 6,547 codes
- North Carolina lab & imaging fee schedule · 1,935 codes
- North Carolina dme & supplies fee schedule · 1,051 codes
- North Carolina drugs fee schedule · 369 codes
- North Carolina other services fee schedule · 91 codes
- North Carolina vision fee schedule · 47 codes
Behavioral Health rates in neighboring states
Frequently asked questions
What does North Carolina Medicaid pay for behavioral health services?
North Carolina Medicaid publishes 24 behavioral health procedure rates effective 2025, paying a median 63.3% of the national Medicare amount for the same services. The schedule covers psychotherapy, psychiatric evaluations, substance-use treatment, and community mental health services. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do North Carolina's behavioral health rates compare with Medicare?
Across behavioral health codes with a national Medicare comparator, North Carolina Medicaid pays a median 63.3% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do behavioral health services need prior authorization in North Carolina?
North Carolina does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from North Carolina's published Medicaid fee-for-service schedule (effective 2025), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time North Carolina changes these rates.