CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Albany Medical Center Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $146
Cash Discount Price: $112
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Albany Medical Center Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.81x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $112 (62%)

Insurance Median: $146 (81%)

Cash: $112 (62% of Medicare)

Ins. Median: $146 (81% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$38 - $293	21%
Emblem	$41 - $285	23%
Emblem_Ghi	$41 - $285	23%
Empire Plan Nyship	$41 - $148	23%
Magnacare	$41 - $285	23%
Multiplan	$43 - $303	24%
Medicaid / KanCare	$48 - $128	26%
Blue Shield	$51 - $318	28%
Carelon Beacon Behavioral	$69 - $177	38%
Cdphp	$91 - $428	50%
Mvp	$96 - $236	53%
Blue Cross Blue Shield	$100 - $428	55%
Medicare (plans)	$100 - $164	55%
Tricare	$100 - $152	55%
Fidelis	$105 - $428	58%
Hamaspik	$110 - $447	61%
Cigna	$115 - $236	63%
Blue Shield Highmark	$118 - $279	65%
Aetna	$125 - $290	69%
Nascentia	$146 - $167	81%
Emblem Health Ghi	$148 - $330	82%
Nascentia Health Options	$209	115%
Nys Department Of Corrections	$277 - $298	153%
Mvp Commercial	$284 - $373	157%
Mvp Essential Plan	$409	226%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $112.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Albany Medical Center Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.