CPT 90791 · Highmark BS NY · Commercial rates
What Highmark BS NY pays for CPT 90791 — the real reimbursement rate.
Highmark BS NY's published rates for initial evaluation swing by tens of dollars across providers in the same state. See where your contract lands.
Most therapists make
for CPT 90791 in New York
“I assumed all insurers paid roughly the same for 90791. upgrate showed me a 30% range across my four payers — and which payers I was underpaid by. Sent letters to two of them and got bumps from both.”
Pull your real Highmark BS NY contract rate and see where you stand.
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See where you stand with each payer — in 90 seconds
| Payer / CPT | Reimbursement rate range |
|---|---|
| 90791 · Initial evaluation | $154–$187 |
| 90837 · 60-min therapy | $130–$159 |
| 90834 · 45-min therapy | $88–$107 |
| 90847 · Family therapy | $88–$108 |
| 90785 · Interactive add-on | $13–$16 |
| Payers pay different providers based on their credential, locality, experience and individual contract. upgrate can retrieve your specific reimbursement rates and what similar providers make, so you can ask for a higher rate based on real data. | |
Frequently asked questions.
How did you get this data?+
It's public — most therapists just don't know it exists. Since 2022, the federal government has required Highmark BS NY (and every other major insurance company) to publish a giant file showing what they pay every in-network provider. We download those files every month and look up the row that matches your NPI. No leaks, no insider access, no scraping — it's the same data anyone can pull, just turned into something you can actually read.
Will Highmark BS NY find out I'm using upgrate?+
No. upgrate never contacts Highmark BS NY on your behalf. Your NPI is only used to look up your contracted rate inside the Machine-Readable Files Highmark BS NY is federally required to publish under the CMS Transparency in Coverage rule — public data, refreshed monthly.
Can Highmark BS NY drop me for asking for a rate increase?+
Requesting a rate review is a routine contractual right — group practices and billers submit them to Highmark BS NY constantly. The letter upgrate generates is a professional contract-amendment request you send from your own email, not a complaint or dispute.
What does upgrate cost?+
Rate reports are free — every payer, every CPT code, no credit card, no trial. You only pay if you decide to use the negotiation system to actually pursue an increase, and pricing is shown before you ever enter payment info.
How much does Highmark BS NY actually pay therapists?+
Highmark BS NY's reimbursement varies by license (LCSW, LMFT, LMHC, PsyD, MD), ZIP code, and individual contract — two therapists in the same building can be paid 30%+ different for the same CPT code. upgrate pulls your exact Highmark BS NY contract rate from their Machine-Readable File and benchmarks it against in-network peers nearby.
Why is the Highmark BS NY rate range so wide?+
Because reimbursement genuinely varies that much. Highmark BS NY pays a Manhattan PsyD differently from a rural LMHC, a 2024 contract differently from a 2018 one, and a large group differently from a solo provider — all for the same CPT code. The wide band is the honest answer to "what does Highmark BS NY pay therapists?" — your NPI is what narrows it down to your number.
Why does upgrate need my NPI?+
Your NPI is the key Highmark BS NY uses to attach your specific contracted rate inside their Machine-Readable File — without it we can only show state-level ranges. Your first lookup is free with no credit card, and your NPI is stored securely.
What if I'm underpaid by Highmark BS NY?+
That's exactly what upgrate is built for. If your report shows you're below the local in-network benchmark for your license and CPT codes, upgrate can generate a contract-amendment request to Highmark BS NY's provider-relations team — pre-filled with your specific percentile gap and comparable rates — that you review, edit, and send from your own email. Most therapists hear back in 30–60 days. The report is free; you only pay if you want help actually pursuing the increase.
Are you guaranteeing a rate increase?+
No. upgrate doesn't and can't guarantee any specific rate change. We give you the payer's own data and a formal request letter — outcomes depend on your contract, region, and payer relationship.