Illinois Medicaid (HFS), LPHA fee schedule psychotherapy coverage: codes and who can bill
The short answerIllinois HFS pays independently practicing LCSWs, LCPs, LMFTs and LCPCs on the LPHA fee schedule: 90837 is $68.69 per unit plus a $129.63 psychiatric add-on per unit (max 2 units), and 90834 is $46.52 plus $87.78. Group psychotherapy is not on this schedule.
By Javier Alvarez · Updated · 1 min read
1 row: Medicaid (by state) · Illinois. Public policy, not the member's benefits.
Illinois Medicaid (HFS), LPHA fee schedule
HFS Fee Schedule for Licensed Practitioners of the Healing Arts, effective 08/01/2026 · Illinois
| 90791 | Listed [1] |
|---|---|
| 90832 | Listed [1] |
| 90834 | Listed [1] |
| 90837 | Listed [1] |
| 90846 | Not named [1] |
| 90847 | Listed [1] |
| 90853 | Not listed (group psychotherapy is not on this schedule; billable by an FQHC or RHC for LPHAs in those settings) [1] |
| Where it applies | Group psychotherapy is not on this fee schedule; FQHCs or RHCs can bill it when an LPHA renders it in those settings. NCCI edits and medically unlikely edits apply, and a code on the schedule does not guarantee payment. [1] |
| Who can bill | The schedule applies to services rendered by an LCSW, Licensed Clinical Psychologist, LMFT or LCPC practicing independently. Testing codes 96130 to 96137 are billable only by licensed clinical psychologists. [1] |
| Payment | LPHA fee schedule effective 08/01/2026, unit price and max quantity: 90791 $91.58 (max 1), 90832 $35.24 (max 1), 90834 $46.52 (max 2), 90837 $68.69 (max 2), each with a rate effective date of 01/01/25. A psychiatric add-on is multiplied by the units billed and added to the unit price (dates of service from 7/1/2019): 90791 $127.88, 90832 $66.50, 90834 $87.78, 90837 $129.63. 90847 is $52.35 (max 1, effective 04/01/24, no add-on). [1] |
What Illinois Medicaid (HFS), LPHA fee schedule's documents say
The table above has every field we found for Illinois Medicaid (HFS), LPHA fee schedule, with numbered sources. In short:
- Who can bill. The schedule applies to services rendered by an LCSW, Licensed Clinical Psychologist, LMFT or LCPC practicing independently. Testing codes 96130 to 96137 are billable only by licensed clinical psychologists.
- Where it applies. Group psychotherapy is not on this fee schedule; FQHCs or RHCs can bill it when an LPHA renders it in those settings. NCCI edits and medically unlikely edits apply, and a code on the schedule does not guarantee payment.
- Codes. 90791, 90832, 90834, 90837 and 90847 are listed. 90846 is not named in this policy. 90853 is not listed.
Codes we checked at Illinois Medicaid (HFS), LPHA fee schedule
What Medicaid's own text says about one code: 90837.
Check Illinois Medicaid (HFS), LPHA fee schedule's claim against the row
Before the claim goes out, compare it with the row above: the code matches the session length you documented, the place of service and modifier fit a video or audio-only visit, and the rendering clinician's license is one the payer enrolls. The psychotherapy table compares Medicaid with every other payer we checked.