Anthem Blue Cross and Blue Shield Behavioral Health Reimbursement Rates in Georgia (2026)

In Georgia, “Anthem Blue Cross and Blue Shield” is the trade name of Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., the Elevance Health subsidiary that dropped the old Blue Cross and Blue Shield of Georgia branding in January 2019. Under the federal Transparency in Coverage rule, that entity discloses every negotiated rate it pays, in machine readable files republished monthly. There is no rate lookup page behind them and no single “Anthem Georgia rate” inside them: what a therapy session allows depends on the employer group or marketplace plan, the clinician’s credential, and the contract behind each arrangement.

This page is Fuse’s aggregation of those files. Our software read Anthem’s September 2026 Georgia network file in full, 11 gigabytes of pricing data once unpacked, pulled every dollar-denominated fee schedule rate for the three CPT codes below, matched each listed NPI against the federal NPPES registry, kept individual behavioral health clinicians whose registered practice location is in Georgia, and computed statistics across distinct provider-rate pairs so a clinician appearing in many plans counts once per distinct rate. Anthem publishes all of its states’ files in one national index alongside BlueCard mirrors of other Blues plans, so scoping the pool to genuine Georgia arrangements is the first methodology decision everything else rests on.

Anthem’s Negotiated Behavioral Health Rates in Georgia by CPT Code

Anthem Blue Cross and Blue Shield publishes negotiated rates for behavioral health services through its Georgia machine readable files. The table below reflects September 2026 data for three commonly billed codes.

CPT Code	Description	Mean Negotiated Rate	Median Negotiated Rate	Min	Max	Unique NPI Count
90791	Psychiatric Diagnostic Evaluation	$138.84	$118.71	$88.00	$606.15	13,349
90837	Psychotherapy, 60 minutes	$123.95	$104.94	$84.60	$509.83	13,349
96130	Psychological Testing Evaluation, 1st hour	$121.99	$88.71	$74.11	$417.05	12,487

Rates extracted from Anthem’s September 2026 Georgia machine readable files.

The files carry an as-of date and are replaced monthly, so the table is labeled with its extraction month and will drift as Anthem updates its disclosures.

Georgia Telehealth Law Guarantees the In-Person Rate

Georgia is one of the states where telehealth payment parity is written into statute, and for behavioral health the statute goes a step further than most. O.C.G.A. section 33-24-56.4, revised by House Bill 307 in 2021, requires insurers to reimburse a service delivered through telemedicine “on the same basis and at least at the rate” paid for the same service in person. The same law makes mental and behavioral health the only service category where insurers must also pay for audio-only visits, and it bars separate telehealth deductibles and requirements that a patient be seen in person first.

Whether that protection applies to a given session depends on one question: how the patient’s plan is funded. Fully insured plans issued in Georgia are state-regulated, so the parity requirement binds them. Self-funded employer plans, which cover a large share of commercially insured Georgians, answer to federal ERISA rules instead, and nothing in Georgia law sets their telehealth rates. For a practice with a heavy virtual caseload, the funding split means the rates in the table above are the operative telehealth benchmark for state-regulated business, while self-funded business pays whatever the contract says. The member ID card and an eligibility check reveal which side a patient sits on.

Prior Authorization at Anthem Georgia: Carelon Runs Behavioral Health

Behavioral health utilization for Anthem’s Georgia commercial plans is managed through Carelon Behavioral Health, the Elevance Health subsidiary formerly known as Beacon Health Options. Authorization requests are submitted through the Authorization application in Availity Essentials under Anthem’s payer ID, and Carelon’s clinical staff handle the review even though the front door is the same portal medical providers use. Routine outpatient psychotherapy generally does not carry blanket precertification on commercial plans, while higher levels of care such as intensive outpatient, partial hospitalization and residential treatment do require authorization.

The operational consequence for a Georgia practice is that two organizations hold pieces of the relationship: Anthem holds the network contract and pays the claims, while Carelon holds credentialing files and medical-necessity review for behavioral services. When network status or an authorization stalls, knowing which of the two owns the queue saves weeks.

Georgia Medicaid Prices Behavioral Health on Two Tracks

Georgia Medicaid is useful context for the commercial numbers because it prices the same services through two entirely different systems. Office-based physician services follow the state’s physician fee schedule, published quarterly on the GAMMIS portal with per-code maximums. Community behavioral health services follow a separate schedule with a structure commercial contracts do not use: rates tier by practitioner level rather than negotiation, and the same code pays more delivered out of clinic than in clinic. Under the update effective July 2024, a psychiatric diagnostic evaluation (90791) pays a level 2 practitioner, such as a licensed psychologist, $159.17 in clinic and $188.12 out of clinic, while a level 3 practitioner bills $108.72 and $130.47 for the identical service. Telehealth pays the in-clinic rate.

Neither track is negotiable, which is exactly why the comparison matters: Anthem’s commercial rates in the table above are the product of thousands of separate contract negotiations, and where a practice’s contract lands against the administered Medicaid floor is one signal of how much negotiating room exists.

Self-Pay Therapy Rates in Atlanta and Across Georgia

Published cash schedules from Georgia practices put goalposts around the commercial figures. Powers Ferry Psychological Associates in Marietta publishes per-clinician fee schedules that run from $170 to $300 for an initial consultation billed as 90791 and $150 to $200 per hour for individual therapy billed as 90837, with masters-level clinicians at the low end and doctoral-level at the top. The Aguirre Center for Inclusive Psychotherapy in Atlanta publishes intake sessions from $200 to $300 and individual therapy from $150 to $225, with rates varying by the clinician’s education and experience, a private-pay echo of the practitioner-level tiers Georgia Medicaid formalizes.

Cash pricing for psychological testing (96130) is rarely published per code in Georgia; practices typically quote testing as a bundled assessment package spanning intake, administration and report writing.

What This Means for Your Practice

The numbers above reflect choices: which network files we read, which rate types we counted, which credentials we included, and who counted as practicing in Georgia. Set those filters differently and the averages move. That is why the method is spelled out above, and why the table is a market reference, not a quote for any one contract.

The number that governs your revenue is the one in your remittances. Pull what Anthem actually paid your practice per code, check it against your contracted schedule, and set both against the statewide medians here. If your 90837 sits below the median, the payer’s own federal disclosure shows more than half of its Georgia arrangements pay better, which is a concrete opening for a rate conversation. The same comparison surfaces underpayments: a contract only pays what it says if someone checks.

Fuse does this work for practices: CPT-level verification of benefits before the visit, reimbursement checks against past claims, and analytics that flag the gap between contracted and paid before it compounds.

Verify Anthem Benefits Before the Visit

A statewide benchmark cannot say what one patient’s plan allows for one visit, particularly in a state where the telehealth rate turns on plan funding and behavioral authorizations route through Carelon. Fuse verifies current eligibility and plan-specific benefits at the CPT code level before the appointment, combining past claims data with automated calls to payers, so the practice knows the expected copay, coinsurance and deductible before the patient sits down. See how CPT-level verification works for behavioral health practices.

Disclaimer: This article uses rate information from the Machine Readable Files that Anthem Blue Cross and Blue Shield publishes under the federal Transparency in Coverage rule. These files are posted to satisfy the regulation, not to be read: the data behind this analysis unpacks to 11 gigabytes of raw pricing, millions of negotiated rates that no spreadsheet can open. Fuse built software that reads it in full and verifies the figures above. This analysis focuses on a single payer and will not reflect rates from all available insurance options in Georgia. Fuse makes every effort to provide accurate and current information, but healthcare pricing can change frequently, and individual circumstances may affect actual costs. This information does not guarantee specific pricing. Practices should verify current rates directly with Anthem before relying on them for billing or negotiation decisions.