CPT 90836
Global ZZZ ActivePsytx w pt w e/m 45 min
CPT 90836 Billing & Documentation Guide
CPT code 90836 (Psytx w pt w e/m 45 min) is classified under Psychiatry with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.17, a non-facility practice expense RVU of 0.84, and a malpractice RVU of 0.08, a total non-facility RVU of 3.09 and facility RVU of 2.49. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $105.53, though rates vary from $97.96 to $140.07 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 90836, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 90836 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 90836 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 90836
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.17 | 2.17 |
| Practice Expense RVU | 0.84 | 0.24 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVU | 3.09 | 2.49 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 90836
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $109.72 | $86.01 | $105.89 - $122.34 | 29 |
| Florida | $105.83 | $85.72 | $103.32 - $108.44 | 3 |
| Georgia | $102.55 | $83.44 | $100.69 - $104.41 | 2 |
| Illinois | $104.95 | $85.59 | $102.27 - $107.32 | 4 |
| Michigan | $102.59 | $83.77 | $101.11 - $104.06 | 2 |
| North Carolina | $100.36 | $81.67 | $100.36 - $100.36 | 1 |
| New York | $110.85 | $88.49 | $101.01 - $115.44 | 5 |
| Ohio | $100.79 | $82.49 | $100.79 - $100.79 | 1 |
| Pennsylvania | $103.47 | $83.84 | $100.76 - $106.18 | 2 |
| Texas | $102.98 | $83.25 | $100.49 - $104.68 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 90836
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 90836 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0359T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0360T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0361T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0362T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0363T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0364T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0365T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0366T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0367T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 90836
What does CPT code 90836 mean? +
CPT code 90836 represents: Psytx w pt w e/m 45 min. It's in the Psychiatry category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 90836? +
The 2026 Medicare national average non-facility payment for CPT 90836 is $105.53. Rates range from $97.96 to $140.07 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 90836? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 90836? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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