CPT 90870
Global 000 ActiveElectroconvulsive therapy
CPT 90870 Billing & Documentation Guide
CPT code 90870 (Electroconvulsive therapy) is classified under Psychiatry with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.5, a non-facility practice expense RVU of 2.86, and a malpractice RVU of 0.09, a total non-facility RVU of 5.45 and facility RVU of 2.95. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $187.48, though rates vary from $167.11 to $232.05 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 90870, 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 90870 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 90870 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 90870
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.5 | 2.5 |
| Practice Expense RVU | 2.86 | 0.36 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 5.45 | 2.95 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 90870
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 | $201.16 | $102.35 | $191.23 - $232.05 | 29 |
| Florida | $185.2 | $101.42 | $179.34 - $190.55 | 3 |
| Georgia | $178.36 | $98.7 | $172.3 - $184.42 | 2 |
| Illinois | $181.84 | $101.16 | $175.42 - $187.52 | 4 |
| Michigan | $177.43 | $99.02 | $174.11 - $180.75 | 2 |
| North Carolina | $174.55 | $96.64 | $174.55 - $174.55 | 1 |
| New York | $198.12 | $104.96 | $176.37 - $208.01 | 5 |
| Ohio | $173.75 | $97.51 | $173.75 - $173.75 | 1 |
| Pennsylvania | $181.04 | $99.25 | $174.04 - $188.03 | 2 |
| Texas | $180.8 | $98.59 | $173.22 - $187.4 | 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 90870
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 90870 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00104 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0115T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0116T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0213T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 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 |
Frequently Asked Questions, CPT 90870
What does CPT code 90870 mean? +
CPT code 90870 represents: Electroconvulsive therapy. It's in the Psychiatry category with a global period of 000.
What is the Medicare reimbursement for CPT 90870? +
The 2026 Medicare national average non-facility payment for CPT 90870 is $187.48. Rates range from $167.11 to $232.05 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 90870? +
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 90870? +
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 June 1, 2026.
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