Official Illinois Medicaid FFS for CPT 90853 (Group psychotherapy) is $33.70 from HFS Practitioner, effective 2026-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $29.91 to $31.02 across 4 CMS localities. Source: CMS RVU26D, October 2026 release and the official Illinois fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. Illinois Medicaid FFS effective 2026-07-01 (HFS Practitioner).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Chicago | $31.02 | $24.98 | $33.70 | Coming soon | CMS MPFS |
East St. Louis | $30.12 | $24.59 | $33.70 | Coming soon | CMS MPFS |
Rest Of Illinois | $29.91 | $24.43 | $33.70 | Coming soon | CMS MPFS |
Suburban Chicago | $31.02 | $24.84 | $33.70 | Coming soon | CMS MPFS |
Compare an offered CPT 90853 rate in Illinois 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. Aetna and Anthem stay Coming soon.
Questions
What is the Illinois Medicaid FFS amount for CPT 90853?
Official Illinois Medicaid FFS is $33.70 from HFS Practitioner, effective 2026-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90853 in Illinois?
For CPT 90853 (Group psychotherapy) in Illinois, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $29.91 to $31.02 across 4 CMS localities. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does Illinois Medicaid FFS compare to Medicare for CPT 90853?
Illinois Medicaid FFS is $33.70; Medicare non-facility PFS is $29.91 to $31.02. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/practitioner.html.
Where is the official Illinois Medicaid FFS source for CPT 90853?
Illinois Department of Healthcare and Family Services: Practitioner Fee Schedule Effective 07/01/2026 Updated 08/11/2026. Source page: https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/practitioner.html. File: https://hfs.illinois.gov/content/dam/soi/en/web/hfs/medicalproviders/medicaidreimbursement/practioner/07012026practitionerfsup08112026.xlsx. Last verified 2026-09-10.
Is this Illinois CPT 90853 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official HFS Practitioner amount $33.70. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.