CPT 90792 Other

How Much Does Psychiatric Evaluation with Medical Services Cost?

Also known as: Psych diag eval w/med srvcs (CPT 90792)

A comprehensive psychiatric evaluation that includes a medical component and may result in medication being prescribed.

Psychiatric Evaluation with Medical Services (CPT 90792) costs $159 at Medicare rates. Hospital outpatient rate: $181.

Cost Comparison by Payer

How much Psych diag eval w/med srvcs costs across different settings and payers

Medicare
Facility rate
$159
Hospital Outpatient
OPPS rate
$181
Medicare (Facility)
$159
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$202
Non-facility setting
Hospital Outpatient
$181
OPPS rate

Patient Guide: Psychiatric Evaluation with Medical Services

What you need to know before your appointment

What to Expect

A psychiatrist will evaluate your mental health, review your medical history, perform relevant medical assessment, and may prescribe medication during this visit.

How Long Does It Take?

60-90 minutes

Common Reasons Doctors Order This

Complex mental health conditions requiring medication, depression with physical symptoms, anxiety requiring prescription treatment

How to Prepare

Bring complete medication list including over-the-counter supplements. Bring any previous psychiatric records or evaluations.

Procedures Commonly Done Together

These procedures are frequently performed alongside Psych diag eval w/med srvcs

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How to Reduce Your Cost for Psych diag eval w/med srvcs

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($202) differs from the facility rate ($159). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

4.16
Work RVU
0.44
Practice Expense RVU
0.17
Malpractice RVU
6.05
Total RVU

Payment = Total RVU (6.05) x CF ($33.40) = $202

Frequently Asked Questions

How much does Psych diag eval w/med srvcs cost?

The Medicare facility rate for Psych diag eval w/med srvcs is $159. In a hospital outpatient setting, the rate is $181. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Psych diag eval w/med srvcs cost without insurance?

Without insurance, the cost of Psych diag eval w/med srvcs can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Psych diag eval w/med srvcs?

Most commercial health insurance plans and Medicare cover Psych diag eval w/med srvcs when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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