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

Anthem Blue Cross and Blue Shield pays Virginia clinicians a median of $164.79 for a 60-minute therapy session (90837). Your own rate depends mostly on two things, your license and whether you practice in Northern Virginia.

Anthem publishes a list of its Virginia plans and the rate file each plan uses. There are 18 rate files. We read 7 of them, 27 gigabytes of pricing data once unzipped. Of the 57,586 plans on Anthem’s October 2026 list, 98% use only those 7 files. That counts plans, not members. The 7 files cover Anthem’s employer plans on the HealthKeepers, KeyCare PPO and Blue ChoiceAdvantage networks, plus its individual plans, including those sold on the Virginia marketplace. The other 11 files are small networks for single employers. We kept dollar rates for professional claims and dropped rows under $5. We matched each NPI against the federal NPPES registry and kept behavioral health clinicians whose practice location is in Virginia.

Each clinician in these files has two rates for the same code. One is for the office. The other, for hospital and facility settings, is 87.5% of the office rate. The figures below are office rates, which is what a private practice bills. A clinician listed at the same rate on several plans is counted once.

What Does Anthem Pay for Therapy and Testing in Virginia?

A 60-minute session, CPT 90837, pays a median of $164.79 at the office rate.

The table covers 15,197 Virginia clinicians with a 90837 rate, 15,197 with a rate for a diagnostic evaluation (90791), and 14,290 with a rate for the first hour of psychological testing (96130).

CPT Code	Description	Mean Negotiated Rate	Median Negotiated Rate	Min	Max	Unique NPI Count
90791	Psychiatric Diagnostic Evaluation	$189.48	$181.33	$116.02	$458.27	15,197
90837	Psychotherapy, 60 minutes	$169.98	$164.79	$103.03	$550.00	15,197
96130	Psychological Testing Evaluation, 1st hour	$130.01	$126.27	$81.16	$319.10	14,290

Rates extracted from Anthem Blue Cross and Blue Shield’s October 2026 machine readable files for Virginia.

A diagnostic evaluation pays a median of $181.33, and the first hour of testing pays $126.27. The average 90837 rate, $169.98, sits above the median because a smaller set of contracts pays much more, up to $550.00. About 4 in 10 clinicians have more than one 90837 rate, because one clinician can belong to several contracted groups.

The median hides a short list of repeated amounts. Five 90837 rates account for about 7 in 10 of the rates in the file. The next two sections explain who gets which one. To see where Anthem’s Virginia rate sits among other Blue plans, read our BCBS 90837 rates by state comparison.

Does Anthem Pay Psychologists and Psychiatrists More Than Counselors in Virginia?

Yes. Outside Northern Virginia, most counselors get $152.66 for 90837, most psychologists get $161.64 and most psychiatrists get $179.60.

Anthem does not publish rates by license. We found them by sorting clinicians by the license in their NPPES record and counting which 90837 rate each one has. In every license group, one rate stands out. Outside Northern Virginia, 83% to 92% of each group has it. We call that the standard rate. About 6 to 7 in 10 clinicians have only that rate. The rest also have a second rate through another group contract, usually a higher one.

The standard office rates step up by license.

• Counselors, clinical social workers and marriage and family therapists. $152.66 for 90837 and $172.70 for 90791.
• Psychologists. $161.64 for 90837 and $182.86 for 90791, about 6% above counselors.
• Psychiatrists and psychiatric nurse practitioners. $179.60 for 90837 and $203.18 for 90791, about 18% above counselors.

Nurse practitioners get the same standard rate as psychiatrists. That makes a psychiatric NP’s therapy hour worth about $27 more than a counselor’s on the same plan.

Testing works differently. Anthem attaches a 96130 rate to most counselors and social workers too, at a standard $120.26. Psychologists, who do most of the testing, have a median of about $129. Check that your own contract lists 96130 before you plan testing hours around it.

Does Anthem Pay More in Northern Virginia?

Yes. The standard rates there run about 12% higher, and about 24% higher for psychologists.

We grouped clinicians by the ZIP code of their practice address. The higher rates follow a clear line.

• Northern Virginia. ZIP codes starting with 201 and 220 to 223. That is Arlington, Alexandria, Fairfax, Falls Church, Loudoun, Prince William and Manassas. About 8 in 10 counselors and social workers there have the higher rate.
• The rest of Virginia. In Fredericksburg and Stafford, about 1 in 3 have the higher rate. From Winchester and Culpeper south and west, about 1 in 5. Across the rest of the state, more than 8 in 10 have the lower rate.

About 1 in 4 of the Virginia clinicians in these files practice in Northern Virginia. Warrenton, in Fauquier County, sits on the edge, with both rates common.

License	90837, rest of Virginia	90837, Northern Virginia	90791, Northern Virginia
Counselors, social workers, MFTs	$152.66	$170.99	$193.44
Psychologists	$161.64	$201.17	$227.58
Psychiatrists and psychiatric NPs	$179.60	$201.17	$227.58

Psychologists gain the most because in Northern Virginia they move up to the same rate as psychiatrists. Richmond, Hampton Roads, Roanoke and the rest of the state share the lower standard amounts.

The rate follows the contract, not only the address. About 1 in 5 counselors outside Northern Virginia carry the higher amount, and about 1 in 5 inside it carry the lower one. If you see patients in Northern Virginia and your 90837 rate is $152.66, ask Anthem which rate tier your contract uses.

Do Anthem’s Individual Plans Pay Less Than Employer Plans in Virginia?

No. For almost every clinician, Anthem’s individual plans pay the same rate as its employer plans.

We compared the 15,108 clinicians who appear in both the individual plan files and the employer plan files. For 14,804 of them, the two sets of files share the same 90837 rate. The median difference was zero. This matters because some payers cut rates for marketplace plans. In Virginia, an Anthem marketplace patient should pay you the same as an employer plan patient for the same session.

How Do Anthem’s Virginia Rates Compare With Medicaid?

Anthem pays more than Virginia Medicaid at every license level, and much more for counselors and social workers.

Virginia Medicaid’s office rate for 90837 is $170.73, effective July 1, 2026. That full rate goes to psychiatrists. State rules pay psychologists 90% of the psychiatrist rate. Clinical social workers, counselors, marriage and family therapists and psychiatric clinical nurse specialists get 75% of the psychologist rate.

License	Medicaid 90837	Anthem 90837 standard rate	Anthem’s margin
Psychiatrists	$170.73	$179.60	about 5%
Psychologists	$153.66	$161.64	about 5%
Counselors, social workers, MFTs	$115.24	$152.66	about 32%

These are the standard rates outside Northern Virginia. Medicaid’s evaluation rate (90791) is $177.22 for psychiatrists and $119.62 for counselors, so Anthem’s $172.70 pays counselors about 44% more.

The gap comes from how much each payer cuts for license. Medicaid pays a counselor about two thirds of the psychiatrist rate. Anthem pays a counselor about 85% of it. For a counselor or social worker, an Anthem session pays about $37 more than Medicaid. For a psychiatrist, it pays about $9 more.

These Medicaid figures are fee-for-service amounts from the state’s fee file, which we checked on October 14, 2026. Most Virginia Medicaid members are in managed care plans, which can pay differently. Anthem’s own Medicaid plan, HealthKeepers Plus, is not in these files, because the federal rule behind them does not cover Medicaid.

Does Anthem Have to Pay the Same Rate for Telehealth Therapy in Virginia?

The law does not say. Virginia requires Anthem to pay for video visits “on the same basis” as in-person care, but it never names a rate or amount.

Section 38.2-3418.16 of the Virginia Code covers state-regulated policies issued or renewed since January 1, 2021. The Center for Connected Health Policy, which tracks state telehealth laws, lists Virginia as having no explicit payment parity for private insurance.

• Coverage. The plan cannot refuse to cover a service only because it was delivered by video.
• Payment. It must reimburse “on the same basis” as the same service in person. The statute does not mention the rate.
• Patient costs. Copays and deductibles cannot be higher than in person.
• Phone calls. Audio-only calls are not telemedicine under this section. A plan may still choose to cover them.
• Self-funded employer plans. State law does not reach them.

The October 2026 files list no separate telehealth rate for these codes. Each contract has the office rate and the facility rate only. Check your contract and your remittances to see which rate Anthem applies to video sessions.

What This Means for Your Practice

Most Anthem therapy rates in Virginia are standard amounts set by license and region.

• Find your tier. Compare your 90837 rate with the standard amount for your license and region above. Most counselors in Fairfax have $170.99, not $152.66.
• Bill the office setting. Sessions coded to a facility place of service pay 87.5% of the office rate. For a counselor, that is about $134 instead of $152.66.
• Know where the room is. Counselors and social workers already earn about a third more from Anthem than from Medicaid. For psychiatrists and psychologists, the gap is closer to 5%.

When you ask for a raise, the standard amounts give you a fair comparison point. Our guide to negotiating insurance contract rates covers how to make that request, and our guide to looking up a negotiated rate shows how to find your own. For a sibling Anthem state, see Anthem behavioral health rates in Georgia. Fuse compares each payment with your contracted rate and flags underpayments. Reach out if you want that check run on your Anthem claims.

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 files behind this analysis unpack to 27 gigabytes of raw pricing data that no spreadsheet can open. Fuse built its own software to extract and verify the figures above. This analysis focuses on a single payer and will not reflect rates from all available insurance options in Virginia. Fuse makes every effort to provide accurate and current information, but healthcare pricing and coverage policy change frequently, and individual circumstances affect actual payment. This information does not guarantee specific pricing. Practices should verify current rates directly with Anthem Blue Cross and Blue Shield before relying on them for billing or negotiation decisions.