CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $222
Cash Discount Price: $301
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Montefiore Mount Vernon Hospital is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $301. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.22x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.

Cash / Self-Pay

$301

Average discount available for prompt cash payment at this facility.

Insurance Median

$222

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: $301 (166%)

Insurance Median: $222 (122%)

Cash: $301 (166% of Medicare)

Ins. Median: $222 (122% 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
American Postal Workers	$135	74%
UnitedHealthcare	$135 - $222	74%
Healthfirst	$136 - $266	75%
Metroplus	$145 - $294	80%
Amidacare	$163	90%
Blue Cross Blue Shield	$163 - $398	90%
Emblem	$163 - $826	90%
Fidelis	$163 - $286	90%
Medicaid / KanCare	$163	90%
Molina Healthcare Of Ny Affinity	$163 - $368	90%
Mvp	$163 - $335	90%
Wellcare	$165 - $226	91%
Hamaspik	$172 - $176	95%
Vnsny Choice	$188 - $222	104%
Vnsny Select Health	$188	104%
Point Comfort	$222	122%
Villagecaremax	$222	122%
Centerlight	$228 - $244	126%
Partners Health Plan	$233	128%
Longevity	$242	133%
Elderplan	$244	135%
Humana	$244	135%
Cigna	$247 - $275	136%
Northwell	$301	166%
Oscar	$354	195%
Aetna	$559 - $625	308%

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 $301.
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 Montefiore Mount Vernon 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.