Psychiatric evaluation: how much does Medicare pay?

Nationally, the Q3 2026 Physician Fee Schedule pays $173.35 in an office (non-facility) setting and $137.28 in a facility setting for 90791. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.

Procedure · Updated Aug 1, 2026

Psychiatric evaluation: CPT code and Medicare rate

The initial diagnostic assessment at the start of mental-health care, reported typically once per episode of treatment.

Also called: psych evaluation, mental health assessment, diagnostic interview, first psychiatry appointment.

Usually billed as

90791 Psychiatric Diagnostic Evaluation

Office (non-facility): $173.35
Facility: $137.28

National amounts for the Q3 2026 release (July 1 – September 30, 2026), using geographic index values of 1.000. Your local rate differs — open the code page for the locality breakdown.

Related codes

Codes worth checking before you settle on 90791.

Code	What it covers	Office	Facility
90834	Psychotherapy, 45 Minutes	$113.90	$91.85
90837	Psychotherapy, 60 Minutes	$167.00	$135.27

A dash means the code has no national amount in this release — it may be carrier-priced, bundled, or not separately payable. That is never the same as $0.

Common questions

Psychiatric evaluation: which code is it?: 90791 — Psychiatric Diagnostic Evaluation. The initial diagnostic assessment at the start of mental-health care, reported typically once per episode of treatment.
Psychiatric evaluation: how much does Medicare pay?: Nationally, the Q3 2026 Physician Fee Schedule pays $173.35 in an office (non-facility) setting and $137.28 in a facility setting for 90791. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.

Need the rate where you practice?

Every code page carries the full locality breakdown, the RVU and GPCI inputs, and the release that answered.

Open the code page

Keep exploring

All procedures How Medicare pays Office vs. facility rates Check a medical bill

This page maps everyday language to the code a claim normally carries. It is general information about how Medicare prices a service, not coding advice for a specific claim — the correct code always depends on what was actually documented and performed.

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