Medicare pays $167.00 for a 60-minute therapy session in 2026
The full behavioral health fee schedule, pulled from CMS: every psychotherapy and testing code, work RVUs, and what the 2026 conversion factor actually does to your rate.
BH REVCYCLE NEWSROOM / AUG 22 / 7 MIN
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Medicare draws the IOP line at 9 hours a week and PHP at 20 — then prices both off the same per diem
Levels of care as payers actually adjudicate them: the hour thresholds in 42 CFR, the condition codes and APCs that separate PHP from IOP, the codes states use for residential and withdrawal management, and the four places the boundary gets fought.
Denial Decoder — Aug 23CARC 16 with MA130 is a returned claim, not a denial — and it carries no appeal rights
A working reference to the CARC and RARC combinations that actually land on behavioral health remittances: what each code says, why it fires in a BH context, and whether the answer is resubmit, correct, or appeal.
Analysis — Aug 23DOL has not enforced the 2024 parity rule since May 15, 2025 — the statute behind it still applies
What MHPAEA actually requires, what an NQTL comparative analysis contains, and what two years of federal enforcement produced — read against a final rule that is codified, effective, and deliberately not enforced.
Analysis — Aug 23POS 10 pays $31.73 more than POS 02 on a Medicare telehealth therapy hour
One digit on the claim moves a 60-minute session from $135.27 to $167.00. The place-of-service rule, what CMS actually instructs for each telehealth modifier, and why behavioral health keeps flexibilities that general telehealth loses at the end of 2027.
Analysis — Aug 21Medicaid psychotherapy spending hit $6.68 billion, up 156% in seven years
Higher payment per service drove most of it, not more providers. That is the detail that decides whether your rates hold when utilization review catches up.
Exclusives
Beach House Behavioral Health raised $3.2M
The Florida treatment operator sold $3.2M of a $3.5M offering, disclosed in an SEC filing rather than an announcement.
Deal WatchAdvanced Recovery Systems bought Promises, creating a 24-facility operator across 14 states
Two sponsor-backed addiction platforms combined in a market where the exit door has closed. If you compete with them, refer to them, or bill for them, three things change.
Databases
BH Rate Lookup
What a payer actually pays for a behavioral health code, by state, from published in-network rate files.
40 codes18 payersAug 18 updatedPrior Auth Requirements
Which payers require authorization for which level of care, by state and plan type.
50 states6 levelsAug 20 updatedThe BH Prior Auth Index
Denial rates, appeal overturns and turnaround, and where behavioral health diverges from medical/surgical.
Q3 live4 per yearAug 20 updated