Illinois Therapy Reimbursement Rates by Payer: Blue Cross vs UnitedHealthcare (2026)

In Illinois, Blue Cross Blue Shield of Illinois pays more than UnitedHealthcare for a 60-minute therapy session to 97 percent of the clinicians both payers list. The gap is small in the Chicago area and large downstate, where Blue Cross pays more and UnitedHealthcare pays less.

The Blue Cross figures cover all ten of its statewide Illinois networks, PPO and HMO. The UnitedHealthcare figures come from the behavioral health network that Optum, UnitedHealthcare’s sister company, runs for its plans. Both are from September 2026. The one exception to Blue Cross’s lead is psychological testing, where one Optum schedule pays psychologists more.

How Did We Compare Illinois Payers’ Therapy Rates?

We read each payer’s own rate files and kept clinicians whose registered practice address is in Illinois.

• Blue Cross Blue Shield of Illinois. All ten of its statewide network files for September 2026. They cover PPO, TraditionalBlue, Blue Choice PPO, Blue Choice Preferred PPO, Blue Options, MyBlue Plus and four HMO networks.
• UnitedHealthcare. The September 2026 behavioral health file from Optum. It covers Optum’s whole national network, so we kept only clinicians who practice in Illinois. Our UnitedHealthcare behavioral health rates for California come from the same file.

We matched every provider ID number against the federal NPPES registry and kept individual behavioral health clinicians. We kept negotiated dollar rates and dropped percentage and placeholder rows. The table counts each distinct clinician and rate pair once.

Of the 8,788 Illinois clinicians Optum lists with a 90837 rate, 8,206 also have Blue Cross rates, so we could compare what each payer pays the same person. Most therapists have two Blue Cross rates, a higher one in the PPO networks and a lower one in Blue Choice. We compared Optum’s rate with the middle of each clinician’s Blue Cross rates, and for therapists we also checked the lower rate on its own. We call ZIP codes starting with 600 to 608 the Chicago area and the rest of the state downstate.

Illinois Therapy Reimbursement Rates by Payer (2026 Table)

Each row comes from that payer’s machine readable files for the month shown, filtered to individual behavioral health clinicians with an Illinois practice address.

Blue Cross leads on 90837 and 90791. Its 90837 median is $133.67, about $15 above UnitedHealthcare at $118.75. Blue Cross also lists about three and a half times as many clinicians. UnitedHealthcare’s testing median of $216.34 is the one figure where it leads, for reasons covered in the testing section below.

Which Payer Pays Illinois Counselors and Social Workers the Most for 90837?

Blue Cross does, for almost every therapist both payers list. Pooling all networks, the 90837 median for counselors, clinical social workers and marriage and family therapists is $133.67 at Blue Cross and $115.82 at UnitedHealthcare.

Comparing the same people gives the same answer. Of 6,031 therapists with a 90837 rate from both payers, Blue Cross’s middle rate is higher for 97 percent, by about $12.

Most Illinois therapists carry two Blue Cross rates, one for each group of networks. The PPO and TraditionalBlue files pay the higher amount. Blue Choice PPO, Blue Choice Preferred PPO and Blue Options pay about 9 percent less. Even that lower rate beats Optum for 93 percent of these therapists. Our Blue Cross Blue Shield of Illinois behavioral health rates page covers its full table and Illinois’s 2027 rate floor.

Do Illinois Payers Pay Chicago and Downstate Therapists Differently?

Yes, in opposite directions. Blue Cross pays downstate therapists more than Chicago-area therapists, and Optum pays them less.

• Chicago area. Blue Cross pays therapists $133.67 in its PPO and $121.97 in Blue Choice. Optum lists most of them at $118.75 or $115.82.
• Downstate. Blue Cross pays $158.10 in its PPO and $144.85 in Blue Choice. Optum lists about four in five downstate therapists at $110.30, the same median it pays Texas counselors.

So the payer gap depends on where you practice. For the same Chicago-area therapists, Blue Choice beats Optum for 94 percent, but only by about $6. Blue Cross’s PPO beats Optum by about $18. Downstate, Blue Cross pays about $35 more on Blue Choice and about $48 more on its PPO. About one in five of the clinicians on either payer’s list practices downstate.

Which Payer Pays Illinois Psychologists and Psychiatric NPs the Most for Therapy?

Blue Cross, for nearly all of them. Its 90837 rate beats Optum’s for 98 percent of psychologists and 99 percent of psychiatric nurse practitioners listed by both.

• Psychologists. Blue Cross’s PPO pays $162.31 in the Chicago area and $191.97 downstate. Optum lists about half of Chicago-area psychologists at $125.00 and about a third at $154.42. For the 1,069 psychologists on both lists, Blue Cross’s middle rate is about $30 higher.
• Psychiatric nurse practitioners. Blue Cross pays them the same amounts as psychologists. Optum’s median for them is $125.01, close to its therapist rates. For the 268 on both lists, Blue Cross pays about $43 more.
• Psychiatrists. Blue Cross’s middle rate is higher for 95 percent of the 473 on both lists, by about $28. Most psychiatrists bill medication visits with other codes, so treat this as a secondary comparison.

Which Payer Pays More for Psychological Testing (96130) in Illinois?

It depends on your Optum schedule. One pays psychologists $216.34 for the first testing hour, about $40 above Blue Cross’s standard PPO office rate.

Optum lists Chicago-area psychologists on two schedules that trade therapy pay against testing pay:

• Testing schedule. $216.34 for 96130 and $125.00 for 90837. 522 psychologists.
• Therapy schedule. $126.32 for 96130 and $154.42 for 90837. 368 psychologists.

Blue Cross pays psychologists $176.11 for 96130 in an office and $142.55 in a facility on its PPO. Blue Choice pays $117.38 and $95.01. So Optum’s testing schedule beats Blue Cross’s standard office rates, and its therapy schedule sits about $50 below the PPO office rate.

Two things shape the table. Optum also attaches its $216.34 testing rate to about 2,500 Illinois counselors and social workers, on the same schedule as their $118.75 therapy rate, which pulls up its median. Blue Cross’s median mixes office and facility amounts.

How Fast Must Blue Cross and Optum Credential a New Illinois Therapist?

Within 60 days of a completed application, for PPO plans that start or renew on or after January 1, 2027.

Section 370c.4(f) of the Illinois Insurance Code sets the rule. That rule also binds “any contracted third party administering the behavioral health benefits for the insurer” on the same terms. The Department of Insurance’s September 11, 2026 bulletin says that covers a company running the network for an insurer, even without a direct contract with you. So the rule reaches Optum as well as Blue Cross. It sets four rules.

• The deadline. The payer must finish contracting, including checking your credentials, within 60 days of a completed application. An application counts as complete once it has all the information the payer’s own credentialing procedures require. If the payer misses the deadline, the Department of Insurance can fine it $1,000 per violation, but you do not get a contract automatically.
• Pay back to the application date. Once your contract starts, the plan must pay your contracted rate for care given since the date your application was complete. Submit those claims only after the contract starts, then tell the patient the visits may be treated as in-network.
• Supervised care while you wait. The plan must cover care from a fully licensed clinician whose application is complete, when a participating clinician in the same group practice supervises. Bill under the supervisor’s NPI.
• What to send. The payer must give you its credentialing policies on request. It must also post its application requirements, a checklist and a contact person on its website.

The rule covers state-regulated PPO plans. It does not cover HMO plans such as HMO Illinois, self-funded employer plans other than those of Illinois local governments and school districts, or group policies issued in another state. Psychiatrists already had a 60-day credentialing limit under the Health Care Professional Credentials Data Collection Act. If a payer misses the deadline, you can file a complaint with the Department of Insurance.

What This Means for Your Practice

If you are adding clinicians in Illinois, apply first to the payer that pays their license the most where they practice. Each payer credentials clinicians separately, so the order decides which patients a new hire can see first and at what rate.

• Downstate therapists. Apply to Blue Cross first. Its PPO pays $158.10 and Blue Choice $144.85 for 90837, against $110.30 at Optum.
• Chicago-area therapists. Apply to Blue Cross first for its PPO rate of $133.67. Optum at $118.75 and Blue Choice at $121.97 are close behind, so the second application matters less.
• Psychologists. Apply to Blue Cross first for therapy. If testing fills much of your week, ask Optum which schedule it will offer before you sign. Its $216.34 testing rate beats Blue Cross’s standard office rate, but it comes with $125.00 for 90837.
• Psychiatric nurse practitioners. Apply to Blue Cross first. It pays them the psychologist amount, about $43 more than Optum for a 60-minute session.

From 2027, keep a record of the date each application was complete. That date starts the 60-day clock and sets how far back the plan must pay once the contract starts. If the rate a new clinician is offered sits well below the median for their license, our guide to negotiating insurance contract rates covers how to ask for more. For the same comparison in Texas, see our Texas therapy rates by payer.

The contracted rate is only half of the picture. Fuse tracks what every payer actually pays on your claims, so you can see which payers pay what they agreed and which do not.

Disclaimer: This article uses rate information from the Machine Readable Files that Blue Cross and Blue Shield of Illinois and UnitedHealthcare publish under the federal Transparency in Coverage rule. These files are posted to satisfy the regulation, not to be read, and Fuse built its own software to extract and verify the figures above. This analysis covers two payers and will not reflect rates from every insurer in Illinois. Healthcare pricing changes frequently, and individual contracts and circumstances affect actual payment. This information does not guarantee specific pricing. Practices should verify current rates directly with each payer before relying on them for billing or negotiation decisions.