Vermont Medicaid Behavioral Health Fee Schedule 2026

Vermont Medicaid publishes 44 behavioral health procedure rates effective 2026, paying a median 84.3% of the national Medicare amount for the same services. This page shows published rates for common behavioral health procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full Vermont behavioral health schedule has 44 codes.

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Published codes

44

Behavioral Health procedures on the 2026 schedule

Median % of Medicare

84.3%

vs national Medicare, GPCI-neutral

PA required

1

codes flagged by the state

Common behavioral health procedures and what Vermont Medicaid pays

A curated sample of recognizable procedures from the 44-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.

CodeProcedureVermont rate% of Medicare
90791Psychiatric diagnostic evaluation, no medical services$146.4584.5%
90792Psychiatric diagnostic evaluation with medical services$168.7183.5%
90832Psychotherapy, 30 minutes$72.5284.5%
90833Psychotherapy, 30 minutes, added to an E&M visit$68.0283.5%
90834Psychotherapy, 45 minutes$96.1384.4%
90836Psychotherapy, 45 minutes, added to an E&M visit$86.2683.6%
90837Psychotherapy, 60 minutes$141.0884.5%
90838Psychotherapy, 60 minutes, added to an E&M visit$113.9883.4%
90839Psychotherapy for crisis, first 60 minutes$135.2984.4%
90840Psychotherapy for crisis, each added 30 minutes$65.0384.3%
90846Family psychotherapy without the patient, 50 minutes$89.1884.2%
90847Family psychotherapy with the patient, 50 minutes$92.4384.4%
90849Multiple-family group psychotherapy$33.9484%
90853Group psychotherapy$25.5984.2%
90870Electroconvulsive therapy (ECT)$152.9284%
H0004Behavioral health counseling and therapy, per 15 minutes$30.62--
H0038Self-help/peer services, per 15 minutes$15.09--
H2019Therapeutic behavioral services, per 15 minutes$21.94--

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 Vermont Medicaid fee schedules

Behavioral Health rates in neighboring states

Frequently asked questions

What does Vermont Medicaid pay for behavioral health services?

Vermont Medicaid publishes 44 behavioral health procedure rates effective 2026, paying a median 84.3% 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 Vermont's behavioral health rates compare with Medicare?

Across behavioral health codes with a national Medicare comparator, Vermont Medicaid pays a median 84.3% 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 Vermont?

Vermont publishes prior-authorization flags on its schedule: 1 behavioral health codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.

Where do these rates come from?

Directly from Vermont's published Medicaid fee-for-service schedule (effective 2026), 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 Vermont changes these rates.