No payer publishes one rate for therapy. What you are paid depends on your license, your location, and the contract you signed. Public data still gives a useful range. For instance, in the case of a 60-minute session (CPT code 90837), the contract rates issued by Aetna, UnitedHealthcare, and Cigna are $115, $116, and $70, respectively. Self-reported medians run higher for Aetna and Cigna.
This guide shows the Medicare benchmarks and illustrates how the figures differ from them. You will also find the ranges for each CPT code 90791, 90834, 90837, and 90853, a comparison of in-network fees versus out-of-network pay, and simple instructions for finding your rate. This guide extends our guide to Blue Cross Blue Shield therapy rates to three more payers. Read the short answer first, then jump to the section you need.
Key Takeaways
Aetna, 90837
About $115 in published contract rates, $122 self-reported median.
UnitedHealthcare, 90837
About $116 in published contract rates.
Cigna, 90837
About $70 in published contract rates, $95 self-reported median.
Medicare benchmark, 90837
Approximately $167.00, national
average.
The Short Answer: What Each Payer Pays for 90837
The CPT code 90837 is the code used for 60-minute psychotherapy, and it has the most data. Two types of data exist, and they measure different things.
CPT 90837 Rates by Payer and Source
| Source | Aetna | UnitedHealthcare | Cigna |
| Published contract rates, master’s level clinicians (Paneled, July 2026) | $115 typical, range $115 to $129 | $116 typical, range $116 to $125 | $70 typical, range $70 to $99 |
| Self-reported medians (therapistrates.org, 2026) | $122 from 146 reports, range $78 to $251 | No reliable figure found | $95 from 94 reports, range $39 to $270 |
Treat every number as a guide. Paneled draws on contracted rates in CMS Transparency in Coverage files. Therapistrates.org collects rates that clinicians report themselves, and says they are unverified.
Why You Will Not Find One Rate for Each Payer
A payer rate is a contract term, so it changes from clinician to clinician.
Contracts Are Set One at a Time
TheraThink, which averages fee schedules shared with it, says contracted rates can change and are set individually at signing. Two therapists with the same payer and the same code can be paid different amounts.
The Data Sources Measure Different Things
Published rate files show what a payer has on record. Self-reported data shows what clinicians say they are paid, and it comes from self-selected samples. The averages presented by TheraThink apply to all codes collectively and are as follows: $78 to $98 for Aetna; $73 to $86 for UnitedHealthcare and Optum; and $71 to $92 for Cigna. This is a different assessment. Comparisons should be made between similar codes.
Location and Contract Route Move the Rate
Rates also move by state. Paneled notes that Cigna in Iowa shows $141, above its $70 to $99 national range. For Cigna 90837, therapistrates.org reports a $100 median for direct contracts and $73 for one platform route, though that platform figure rests on five reports.
Rates by CPT Code
Four codes cover most therapy billing. Data is thinner for some than others, and we say so where it is.
Payer Rates by CPT Code Against the Medicare Benchmark
| CPT code | Medicare 2026 (approx. national) | Aetna self-reported median | Cigna self-reported median | UnitedHealthcare |
| 90791 (diagnostic evaluation) | $173.35 | $126 (17 reports) | $106 | No reliable figure found |
| 90834 (45-minute session) | $113.90 | $101 (23 reports) | $76 | No reliable figure found |
| 90837 (60-minute session) | $167.00 | $122 (146 reports) | $95 (94 reports) | About $116 in published contract rates |
| 90853 (group, per patient) | $30.39 | No data found | No data found | No data found |
CPT 90791: Diagnostic Evaluation
Use 90791 for the first evaluation. Medicare is known to pay about $173.35. The median payment offered by Aetna is $126 and is based on about 17 claim settlements, so it is important to keep in mind that it is a very rough estimate.
CPT 90834: 45-Minute Psychotherapy
Medicare pays approximately $113.90. Aetna’s reported median is $101, and Cigna’s is $76. Both come from small samples, and the Aetna figure uses 23 reports.
CPT 90837: 60-Minute Psychotherapy
This code has the strongest data. Medicare pays approximately $167.00. Our CPT 90837 billing guide covers the time rule and documentation that protect this claim.
CPT 90853: Group Psychotherapy
Medicare pays around $30.39. Reliable information for a group payment under the code 90853 cannot be obtained from Aetna, United Healthcare, or Cigna. It is essential to get the payment information in writing from the insurers before the program is rolled out.
In-Network vs Out-of-Network Pay
In-network, the payer pays the rate in your contract. For out-of-network billing, there is no contract rate, and thus the payer uses allowed amounts.
How In-Network and Out-of-Network Payment Differ
| Point | In-network | Out-of-network |
| Who sets the rate | The contract you signed | The payer, through its allowed amount |
| What you see up front | A fee schedule once you are accepted | Usually nothing until a claim is paid |
| What the patient owes | A copay or coinsurance on the contract rate | Coinsurance on the allowed amount, plus any difference from your fee, depending on the plan |
| Claim experience | Standard process | One vendor reports higher denial rates and longer payment cycles |
An allowed amount is set either by plan-specific rates or by a usual, customary, and reasonable (UCR) table, according to Nirvana. It adds that insurers rarely disclose allowed amounts. Mentaya gives an example: a $200 session with a $180 allowed amount and 80 percent out-of-network coverage pays $144. The patient picks up the rest. Treat that as an illustration, since plans differ.
What Changes the Rate You Are Paid
- License. Medicare calculates and pays only 75% of the fees for licensed clinical psychologists for independent billing of payments to LCSWs, whereas commercial agreements may vary among professionals according to their license type. Check yours.
- State and area. The same payer can pay very differently across states.
- Contract route. Direct contracts and platform routes can pay different amounts for the same code.
- Place of service. Medicare reimburses higher in the office than in a facility setting.
- Telehealth rules. Telehealth regulations depend on payer and the service date.
How to Find Your Actual Rate
- Open your contract and fee schedule. The rate for each code is there.
- Check your remittances. Pull paid amounts for 90791, 90834, 90837, and 90853 from your last three months of ERAs.
- Compare with Medicare. Divide the reimbursement by the Medicare rate for your license. Large variations in rates can necessitate further discussion.
- Look for underpayments. A paid amount below your contract rate is an error to dispute.
- Ask the payer. Make sure to request a current fee schedule in writing before you negotiate or renew your contract.
About the Data in This Guide
Every figure here has a date and a limit, so you can judge it yourself.
- Medicare 2026 amounts are national figures from the CMS Physician Fee Schedule as reported by TheraThink. Your local amount differs by area and place of service.
- Paneled reports typical contracted rates for master’s level clinicians (LCSW, LMHC, LMFT) from CMS Transparency in Coverage files, as of July 2026. It calls them a guide, not a quote.
- Therapistrates.org collects rates that clinicians report themselves. The Aetna page was updated on October 26, 2026. All entries are unverified, the sample is self-selected, and about 14 percent of reports come from California.
- Small samples need care. Aetna’s median for 90791 and 90834 is based on 17 and 23 reports.
When you approach a payer with a request for a higher rate, be sure to provide copies of your remittance advice, Medicare rate for your license, and the published range for your state. A request backed by your own paid claims is easier to answer than a general one.
How A2Z Helps Behavioral Health Practices
Our team checks paid claims against contract rates and flags underpayments so you can see where revenue is slipping. Our mental health billing services cover therapy practices, and our psychiatry billing services cover prescribers.
Frequently Asked Questions
How much does Aetna pay for 90837?
Published contract rates for master’s level clinicians sit around $115, with a range of $115 to $129. Clinicians report a median of $122 across 146 reports. Your contract decides the real figure.
How much does UnitedHealthcare pay for therapy?
Published contract rates show about $116 for 90837, with a range of $116 to $125. We could not find a reliable figure for the other three codes.
How much does Cigna pay for therapy?
Cigna’s published 90837 rate is about $70, with a range of $70 to $99. Clinicians report a median of $95 across 94 reports. That gap shows how much contracts vary.
Why do the numbers differ between sources?
One source uses contract rates filed with CMS, and another uses what clinicians report. They draw on different samples, license levels, and years, so they do not match.
Do payers pay more than Medicare for therapy?
In the data above, usually not. Medicare pays approximately $167.00 for 90837, and the commercial figures sit below it. Medicare pays independently billing LCSWs 75 percent of that amount, so compare against the figure for your license. Your contract can differ.
Is out-of-network pay higher than in-network pay?
It can be, but it is less certain. The payer has a defined rate that you usually cannot know beforehand, and the customer bears more of the expense.
What does a payer pay for group therapy (90853)?
It is not easy to find dependable information about reimbursement for the 90853 code. As a rule, Medicare reimburses about $30.39 per patient, so it is advisable to ask the insurers to provide information about their reimbursement levels in writing.
Final Thoughts
Payers have a range of prices for therapy, for which your contract defines your position. The Medicare rate and your personal reimbursements should help you understand your position, while also requesting the fee structure before signing or renewing any contract. If you are in need of a team to provide tracking assistance, we offer this service.
