Ryan White Part B Allowable Services (2025-2026) Fee Schedule: Mental Health Services Capped at 52 Visits per Ryan White Part B Grant Year
The Ryan White Part B rate for 2025-2026 is based on average rates listed for mental health professionals in the 2025 Medicaid behavioral health fee schedule and Centers for Medicare and Medicaid Services (CMS) guidelines. The 52 visit limit is based on total sessions during the Ryan White Part B grant year that begins on April 1 and ends on March 31.
Service Code 24.1 - Evaluation and Counseling
| HCPCS Code (CPT) | Description | Medicaid Rate | Ryan White Rate | Notes |
| 90791 | PSYCHIATRIC DIAGNOSTIC EVALUATION. | Varies | $130.72 | Preauth and Tx plan (1 per Ryan White Part B grant year). |
| 90792 | PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES. | Varies | $144.35 | Preauth and Tx plan (1 per Ryan White Part B grant year). |
| 90832 | PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY. | Varies | $63.11 | Preauth and Tx plan. |
| 90833 | PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN E AND M SERVICE. | Varies | $65.37 | Preauth and Tx plan. |
| 90834 | PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY. | Varies | $82.05 | Preauth and Tx plan. |
| 90836 | PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN E AND M SERVICES. | Varies | $83.03 | Preauth and Tx plan. |
| 90837 | PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY. | Varies | $120.36 | Preauth and Tx plan. |
| 90838 | PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN E AND M SERVICES. | Varies | $109.53 | Preauth and Tx plan. |
| 90839 | PSYCHOTHERAPY FOR CRISIS; FIRST 60 MINUTES. | Varies | $171.70 | Preauth and Tx plan. |
| 90840 | PSYCHOTHERAPY FOR CRISIS; EACH ADDITIONAL 30 MINUTES. | Varies | $81.95 | Preauth and Tx plan. |
| 90847 | FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY)(WITH PATIENT PRESENT). | Varies | $100.72 | Preauth and Tx plan. |
| 90853 | GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP). | Varies | $33.09 | Preauth and Tx plan. |
Service Code 24.25 - Medication Management
| HCPCS Code (CPT) | Description | Medicaid Rate | Ryan White Rate | Notes |
| 99201 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT (MD/DO). TYPICALLY, 10 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. | Varies | $56.02 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99202 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT (MD/DO). TYPICALLY, 20 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. | Varies | $93.14 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99203 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT (MD/DO). TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. | Varies | $135.22 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99204 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT (MD/DO). TYPICALLY, 45 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. | Varies | $207.36 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99205 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT (MD/DO). TYPICALLY, 60 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. | Varies | $260.61 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99211 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT (MD/DO). TYPICALLY, 5 MINUTES ARE SPENT PERFORMING OR SUPERVISING THESE SERVICES. | Varies | $24.54 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99212 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT (MD/DO). TYPICALLY, 10 MINUTES ARE SPENT PERFORMING OR SUPERVISING THESE SERVICES. | Varies | $53.87 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99213 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT (MD/DO). TYPICALLY, 15 MINUTES ARE SPENT PERFORMING OR SUPERVISING THESE SERVICES. | Varies | $91.14 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99214 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT (MD/DO). TYPICALLY, 25 MINUTES ARE SPENT PERFORMING OR SUPERVISING THESE SERVICES. | Varies | $134.50 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99215 | OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT (MD/DO). TYPICALLY, 40 MINUTES ARE SPENT PERFORMING OR SUPERVISING THESE SERVICES. | Varies | $181.67 | Preauth and Tx plan are not required for medication management appointment. No annual cap. |
| 99441 | TELEHEALTH ORIGINATING SITE FEE. | $46.00 | $59.80 | |
| 99442 | PHONE E/M BY PHYS 11-20 MIN. | $76.00 | $98.80 | |
| 99443 | PHONE E/M BY PHYS 21-30 MIN. | $110.00 | $143.00 | |
| Q3014 | TELEHEALTH ORIGINATING SITE FEE. | $29.96 | $38.95 |