UnitedHealthcare Behavioral Health Reimbursement Rates in Illinois (2026)

UnitedHealthcare’s Optum network lists most Illinois therapists at one of three rates for a 60-minute session, $118.75, $115.82 or $110.30. Each is about half of what Illinois will require fully insured PPO plans to pay from 2027.

Optum, UnitedHealthcare’s sister company, runs its behavioral health network and publishes one national rate file for it. We read the October 2026 copy and kept clinicians whose practice address in the federal NPPES registry is in Illinois. UnitedHealthcare’s public disclosures name that file for only a small share of its Illinois plans. The next section explains why we still treat it as UnitedHealthcare’s therapy rates.

Which UnitedHealthcare Plans Use These Illinois Rates?

Probably most of them, because Optum signs up behavioral health clinicians for UnitedHealthcare. UnitedHealthcare’s provider site says Optum “handles credentialing and contracting on behalf of UnitedHealthcare,” so a therapist who joins UnitedHealthcare gets an Optum rate.

UnitedHealthcare’s public disclosures are less clear. Federal rules require it to publish, for each plan, which rate files apply. It names Optum’s file for only about 7 percent of its Illinois plans.

• Optum’s file. It lists 8,705 Illinois behavioral health clinicians with a 90837 rate. UnitedHealthcare Insurance Company of Illinois names it for 287 of the 4,112 plans it lists. UnitedHealthcare of Illinois, its HMO company, names it for 67 of 1,082.
• The medical network files. For the other 93 percent of plans, UnitedHealthcare names only these files, which hold its rates for doctors and hospitals. We read the three largest, Choice Plus, Core and Navigate HMO. Each lists only about 410 to 460 Illinois behavioral health clinicians, led by hospital systems and community health centers. Their 90837 medians run about $187 to $196, and none of these clinicians has the same rate there as in Optum’s file.

If those other plans used only the medical files, they would have almost no therapists in private practice. So the 7 percent most likely means the disclosures are incomplete, not that most plans use a different network. We cannot confirm that plan by plan, and some employer plans may use another company for mental health care. Ask which network a patient’s plan uses when you verify benefits.

Three more limits apply. These counts are plans, not people covered. Medicare Advantage and Medicaid plans are not part of these disclosures. A listed rate does not mean the clinician takes new UnitedHealthcare patients.

What Does Optum Pay Illinois Clinicians for 90837, 90791 and 96130?

The table pools every Illinois license type. We used only the dollar rates Optum lists for clinicians’ own services, not facility rates. Each clinician’s rate counts once, even when it appears under several contracts.

CPT Code	Description	Mean Negotiated Rate	Median Negotiated Rate	Min	Max	Unique NPI Count
90791	Psychiatric Diagnostic Evaluation	$144.78	$137.50	$58.50	$489.51	8,705
90837	Psychotherapy, 60 minutes	$123.02	$118.75	$73.25	$739.94	8,705
96130	Psychological Testing Evaluation, 1st hour	$190.43	$216.34	$84.43	$332.02	4,321

Rates extracted from the Optum behavioral health file in UnitedHealthcare’s October 2026 machine readable files.

Testing is the outlier. The 96130 median of $216.34 sits far above the therapy median because one Optum schedule pays $216.34 for the first testing hour, explained below. Only about one Illinois clinician in sixteen has more than one 90837 rate in the file, so most have a single rate to compare.

Which Optum Schedule Sets an Illinois Therapist’s Rate?

Optum puts most Illinois therapists on one of three fee schedules, and your 90837 rate tells you which one. Where you practice matters, but only partly. The schedule also decides whether you have a testing rate at all.

90837 rate	Where it is common	Therapists listed	Testing (96130) rate
$118.75	Chicago (63% of city therapists) and suburbs (46%)	2,689	$216.34 for 94%
$115.82	Chicago suburbs (39%)	1,848	None for 92%
$110.30	Downstate (80% of therapists there)	1,596	None for 97%

We grouped clinicians by the ZIP code on their NPPES practice address. Chicago means ZIP codes starting with 606 to 608, the suburbs 600 to 605, and downstate everything else.

The schedules are not regional rules. Suburban therapists split between the top two, and some Chicago therapists are on the lower ones. Our Illinois therapy rates by payer compares Optum’s rates with Blue Cross’s for the same therapists.

Do Headway, Alma and SonderMind Pay More Than Optum in Illinois?

Yes, but few Illinois therapists use them. Of the Illinois therapists with an Optum rate for 90837, about 6 percent are listed under a contract with Headway, Alma or SonderMind. In Texas it is 30 percent.

• Headway. 264 therapists, about 4 percent, at $137.78. That is 16 percent above the $118.75 schedule.
• Alma. 96 therapists at $144.40, about 22 percent above it.
• SonderMind. 30 therapists at $127.32.

These are the rates Optum pays each platform, not what the clinician takes home, which depends on each platform’s terms. Our UnitedHealthcare Texas rates cover how these platform contracts work.

Therapists who contract with Optum through their own practice, not a platform, do not get more. The 121 we could identify have a median of $118.75, the same as the top schedule.

How Much More Does Optum Pay Illinois Psychologists and Psychiatrists?

Psychologists’ most common rate is about 5 percent above the top therapist schedule, and psychiatrists’ about 50 percent above it. The common 90837 rates are:

• Psychologists. $125.00 for 46 percent, almost always paired with the $216.34 testing rate. Another 32 percent are listed at $154.42 for therapy but only $126.32 for testing.
• Psychiatrists. $181.25 for a third, then $154.42 and $147.07.
• Psychiatric nurse practitioners. About a third are listed at the $118.75 therapist rate, and most of the rest at $125.01 or $131.26.

So the two psychologist schedules trade off. One pays more for therapy, the other more for testing. If testing fills much of your week, the $125.00 schedule pays more overall.

How Do Illinois UnitedHealthcare Rates Compare With Other States?

Illinois sits near the middle for therapy and at the top for testing. Its 90837 median of $118.75 is about 2 percent below Optum’s national median of $121.33, and 15 of the 35 states with at least 1,000 behavioral health clinicians in the file have a higher median.

For 96130, Illinois’s median of $216.34 is the highest of the 10 states with at least 1,000 clinicians with a testing rate. Minnesota is next at $160.10.

How Far Below Illinois’s 2027 Floor Are Optum’s Rates?

About half, for therapy. From 2027, Section 370c.4 of the Illinois Insurance Code requires covered plans to pay at least 141.7 percent of Medicare’s physician rate for in-network mental health care.

Using 2026 Medicare rates, here is the floor in the area where each Optum schedule is most common.

Optum schedule	Area	2027 floor for 90837	Floor compared with Optum
$118.75	Chicago (Cook County)	$239.40	About 2.0 times
$115.82	Suburban Chicago	$240.17	About 2.1 times
$110.30	Rest of Illinois	$232.23	About 2.1 times

For a Chicago therapist on the top schedule, the floor is about $121 more per session. Nearly all of Optum’s Illinois rates fall short. Of its 90837 rates, 99.6 percent are below $232.23, the lowest floor in the state.

Testing is the exception. Optum’s $216.34 testing rate is already about 19 percent above the highest 96130 floor, $182.21. About three in four Illinois clinicians with a testing rate in Optum’s file are listed at $182.21 or more.

The floor will not cover every UnitedHealthcare patient. The Department of Insurance’s September 11, 2026 bulletin applies it to fully insured PPO plans from each plan’s first plan year starting on or after January 1, 2027. HMO plans and most self-funded employer plans are left out. The actual floor amounts will be based on Medicare’s 2027 rates, and our Blue Cross Blue Shield of Illinois rates page lists the floor for every Medicare area and code.

What This Means for Your Practice

Optum pays Illinois therapists less than Blue Cross, and the 2027 floor will not close the gap for every patient. For a 60-minute session, the medians are:

• UnitedHealthcare (Optum). $118.75 in its October 2026 file.
• Blue Cross Blue Shield of Illinois. $133.67 in its September 2026 files.

Three things to do now.

• Ask which network the plan uses. When you verify a UnitedHealthcare patient’s benefits, ask whether behavioral health runs through Optum. The disclosures do not say for most plans.
• Know your schedule. If your 90837 rate is $115.82 or $110.30 and you do psychological testing, ask Optum about the schedule that includes the $216.34 testing rate.
• Check 2027 PPO payments against the floor. The law puts the duty on the insurer, and Optum runs the network for UnitedHealthcare. For fully insured PPO patients, compare each payment with your Medicare area’s floor once 2027 plan years start, and ask Optum in writing how it applies the floor.

Our guide to negotiating insurance contract rates covers asking for more before then.

Disclaimer: This article uses rate information from the Machine Readable Files that UnitedHealthcare publishes under the federal Transparency in Coverage rule. The Optum behavioral health file is about 80 megabytes unzipped and lists rates for more than 175,000 provider ID numbers nationwide with no names attached. We also read the behavioral health codes in three of UnitedHealthcare’s Illinois medical network files, each far larger. Fuse built its own software to match these rates to clinicians and verify the figures above. This analysis covers a single payer and will not reflect rates from all available insurance options in Illinois. We name platforms only to identify their contracts in the file, not to describe what they pay their clinicians. Healthcare pricing changes frequently, and individual circumstances affect actual payment. Practices should verify current rates directly with UnitedHealthcare before relying on them for billing or negotiation decisions.