How Much Does Psychiatric Diagnostic Evaluation Cost?
Also known as: Psych diagnostic evaluation (CPT 90791)
An initial comprehensive evaluation by a psychiatrist or psychologist to assess your mental health and create a treatment plan.
Psychiatric Diagnostic Evaluation (CPT 90791) costs $137 at Medicare rates. Hospital outpatient rate: $181.
Cost Comparison by Payer
How much Psych diagnostic evaluation costs across different settings and payers
Patient Guide: Psychiatric Diagnostic Evaluation
What you need to know before your appointment
What to Expect
The provider will ask detailed questions about your symptoms, medical history, family history, and daily functioning. They may use questionnaires or standardized tests.
How Long Does It Take?
60-90 minutes
Common Reasons Doctors Order This
New mental health concerns, depression or anxiety evaluation, ADHD assessment, medication evaluation, PTSD diagnosis
How to Prepare
Bring a list of current medications, previous mental health treatment history, and any relevant records. Be prepared to discuss your symptoms openly.
Procedures Commonly Done Together
These procedures are frequently performed alongside Psych diagnostic evaluation
How to Reduce Your Cost for Psych diagnostic evaluation
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 ($173) differs from the facility rate ($137). 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.
Payment = Total RVU (5.19) x CF ($33.40) = $173
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Psych diagnostic evaluation cost?
The Medicare facility rate for Psych diagnostic evaluation is $137. 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 diagnostic evaluation cost without insurance?
Without insurance, the cost of Psych diagnostic evaluation 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 diagnostic evaluation?
Most commercial health insurance plans and Medicare cover Psych diagnostic evaluation 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.