Official Montana Medicaid FFS for CPT 90853 (Group psychotherapy) is $42.72 (facility $34.27) from MT DPHHS Physician, effective 2026-07-01, verified 2026-09-10. CY 2026 Medicare non-facility PFS is $30.39. Source: CMS RVU26D, October 2026 release and the official Montana fee schedule. Not an MCO or commercial rate.
Last updated
Last verified 2026-09-10. Medicare effective 2026-10-01. Montana Medicaid FFS effective 2026-07-01 (MT DPHHS Physician).
| Locality | Medicare non-facility | Medicare facility | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
Montana** | $30.39 | $24.38 | $42.72 | Coming soon | CMS MPFS |
Compare an offered CPT 90853 rate in Montana 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 Montana Medicaid FFS amount for CPT 90853?
Official Montana Medicaid FFS is $42.72 (facility $34.27) from MT DPHHS Physician, effective 2026-07-01, last verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90853 in Montana?
For CPT 90853 (Group psychotherapy) in Montana, the CY 2026 Medicare non-facility Physician Fee Schedule amount is $30.39 across 1 CMS locality. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
How does Montana Medicaid FFS compare to Medicare for CPT 90853?
Montana Medicaid FFS is $42.72; Medicare non-facility PFS is $30.39. These are different programs. The Medicaid cell is official fee-for-service only, not an MCO or commercial contracted rate. Source: https://medicaidprovider.mt.gov/proposedfs.
Where is the official Montana Medicaid FFS source for CPT 90853?
Montana Department of Public Health and Human Services: Montana Healthcare Programs Physician Fee Schedule, July 1, 2026 (posted as Proposed July 2026; DPHHS notice: used for reimbursement starting 2026-07-01). Source page: https://medicaidprovider.mt.gov/proposedfs. File: https://medicaidprovider.mt.gov/docs/feeschedules/ProposedJuly2026/July2026PhysicianServicesFeeSchedule_Proposed.xlsx. Last verified 2026-09-10.
Is this Montana CPT 90853 amount a Medicaid MCO or commercial contracted rate?
The Medicaid FFS cell is the official MT DPHHS Physician amount $42.72. That is fee-for-service, not an MCO rate. Commercial cells remain Coming soon until a parsed in-network file is loaded.