90837 with Illinois Medicaid (HFS), LPHA fee schedule: what the policy says
The short answerYes. Illinois HFS pays $68.69 per unit of 90837 plus a $129.63 psychiatric add-on per unit, up to 2 units, to independently practicing LCSWs, LCPs, LMFTs and LCPCs (LPHA fee schedule effective 08/01/2026). Computed: up to $396.64 for 2 units.
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 policy says about 90837
90837 is the CPT code for psychotherapy, 60 minutes with patient. At Illinois Medicaid (HFS), LPHA fee schedule it is listed: named in the payer's public policy. Each line below is from the cited text:
- Where it is listed. 90837 is on the LPHA fee schedule (effective 08/01/2026), which applies to LCSWs, LCPs, LMFTs and LCPCs practicing independently, and is starred for the psychiatric add-on. (Illinois HFS, checked October 30, 2026)
- When it pays. The add-on applies to dates of service from 7/1/2019. A code on the schedule does not guarantee payment, and NCCI procedure-to-procedure and medically unlikely edits apply. (Illinois HFS, checked October 30, 2026)
- Units. Maximum quantity 2 units. The add-on is multiplied by the units billed, up to the max quantity, and added to the unit price; computed from the schedule, 2 units pay up to $396.64 (2 x $68.69 plus 2 x $129.63). (Illinois HFS, checked October 30, 2026)
- Payment. Unit price $68.69 (rate effective 01/01/25) on the LPHA fee schedule effective 08/01/2026, plus a psychiatric add-on of $129.63 per unit billed. (Illinois HFS, checked October 30, 2026)
90837 at other payers
- 90837 with Medicare: listed.
- 90837 with New York Medicaid (fee-for-service): listed.
The rest of Illinois Medicaid (HFS), LPHA fee schedule's psychotherapy rules
The Illinois Medicaid (HFS), LPHA fee schedule row has its codes, telehealth rule, limits and authorization, each with its source. Before the claim goes out, compare it with the row in the table above.