Official District of Columbia Medicaid FFS for CPT 90834 (Psychotherapy, 45 minutes with patient) is $98.82 (facility $78.05) from DHCF DCPFS26001, effective 2026-01-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $123.52. Source: CMS RVU26D, October 2026 release and the official District of Columbia fee schedule. Not an MCO or commercial rate. The published UnitedHealthcare (Optum Behavioral Health) median is $101.36; the middle 80% of published UHC rates run from $78.73 to $152.36 (file dated 2026-09-01, counted by provider practice state). See what UnitedHealthcare pays in District of Columbia.
Last updated
CMS locality “DC + MD/VA SUBURBS” includes listed Maryland and Virginia suburban counties. Maryland and Virginia also have their own localities.
Last verified 2026-09-10. Medicare effective 2026-10-01. District of Columbia Medicaid FFS effective 2026-01-01 (DHCF DCPFS26001).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
DC + MD/VA Suburbs | $123.52 | $97.56 | $98.82 | $101.36 | CMS MPFS |
Compare an offered CPT 90834 rate in District of Columbia on Contract Checker v1.3 (code and state prefilled). When UnitedHealthcare publishes rates for this code and state, the tool also compares your offer to the UHC median and the middle 80% of UHC rates, alongside Medicare and Medicaid FFS. UnitedHealthcare in District of Columbia (median $101.36).
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Questions
What is the District of Columbia Medicaid FFS amount for CPT 90834?
Official District of Columbia Medicaid FFS is $98.82 (facility $78.05) from DHCF DCPFS26001, effective 2026-01-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90834 in District of Columbia?
For CPT 90834 (Psychotherapy, 45 minutes with patient) in District of Columbia, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $123.52 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does District of Columbia Medicaid FFS compare to Medicare for CPT 90834?
District of Columbia Medicaid FFS is $98.82; Medicare non-facility PFS is $123.52. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://dhcf.dc.gov/publication/transmittal-26-10-notice-pricing-updates-medicaid-ffs-professional-fee-schedule.
What is the UnitedHealthcare commercial median for CPT 90834 in District of Columbia?
UnitedHealthcare Optum Health Behavioral Services (OHBS) professional median is $101.36 (10th percentile $78.73, 90th percentile $152.36; 53 rate rows; 109 NPIs). Source: 2026-09-01 UnitedHealthcare of Ohio, Inc. Optum-Health-Behavioral-Services in-network-rates.json.gz, source file dated 2026-09-01. Counted by provider practice state. Aetna and Anthem stay Coming soon. Not an MCO rate.
Is this District of Columbia CPT 90834 amount a Medicaid MCO or commercial contracted rate?
Medicaid FFS ($98.82) is fee-for-service, not MCO. The commercial column is UnitedHealthcare median ($101.36 median) when loaded; Aetna and Anthem stay Coming soon.