The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Wisconsin behavioral health schedule has 43 codes.
- Every code on all 51 published schedules
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Published codes
43
Behavioral Health procedures on the 2026 schedule
Median % of Medicare
74.4%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common behavioral health procedures and what Wisconsin Medicaid pays
A curated sample of recognizable procedures from the 43-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 | Wisconsin rate | % of Medicare |
|---|---|---|---|
| 90791 | Psychiatric diagnostic evaluation, no medical services | $116.85 | 67.4% |
| 90792 | Psychiatric diagnostic evaluation with medical services | $174.05 | 86.1% |
| 90832 | Psychotherapy, 30 minutes | $56.96 | 66.4% |
| 90833 | Psychotherapy, 30 minutes, added to an E&M visit | $78.40 | 96.2% |
| 90834 | Psychotherapy, 45 minutes | $75.67 | 66.4% |
| 90836 | Psychotherapy, 45 minutes, added to an E&M visit | $99.26 | 96.2% |
| 90837 | Psychotherapy, 60 minutes | $113.43 | 67.9% |
| 90838 | Psychotherapy, 60 minutes, added to an E&M visit | $130.82 | 95.8% |
| 90839 | Psychotherapy for crisis, first 60 minutes | $118.59 | 74% |
| 90840 | Psychotherapy for crisis, each added 30 minutes | $56.64 | 73.4% |
| 90846 | Family psychotherapy without the patient, 50 minutes | $77.49 | 73.2% |
| 90847 | Family psychotherapy with the patient, 50 minutes | $80.83 | 73.8% |
| 90849 | Multiple-family group psychotherapy | $76.39 | 189% |
| 90853 | Group psychotherapy | $28.00 | 92.1% |
| 90870 | Electroconvulsive therapy (ECT) | $208.92 | 114.8% |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $15.95 | -- |
| H0031 | Mental health assessment, by non-physician | $38.10 | -- |
| H0038 | Self-help/peer services, per 15 minutes | $3.58* | -- |
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 Wisconsin Medicaid fee schedules
- Wisconsin physician fee schedule · 6,678 codes
- Wisconsin lab & imaging fee schedule · 2,101 codes
- Wisconsin dme & supplies fee schedule · 1,837 codes
- Wisconsin drugs fee schedule · 973 codes
- Wisconsin other services fee schedule · 263 codes
- Wisconsin vision fee schedule · 144 codes
Behavioral Health rates in neighboring states
Frequently asked questions
What does Wisconsin Medicaid pay for behavioral health services?
Wisconsin Medicaid publishes 43 behavioral health procedure rates effective 2026, paying a median 74.4% 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 Wisconsin's behavioral health rates compare with Medicare?
Across behavioral health codes with a national Medicare comparator, Wisconsin Medicaid pays a median 74.4% 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 Wisconsin?
Wisconsin 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 Wisconsin'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 Wisconsin changes these rates.