How Much Does a Psychiatric Evaluation Cost in Arizona?
Psych diagnostic evaluation
$171.88In-office total2026 Medicare, Arizona averageUnder 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $172 in Arizona, with no separate facility fee. In a facility the national total is up to about $319 at a hospital outpatient department, because the facility is paid its own rate on top of the physician.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Arizona Medicare physician rate (2026)
-0.8% vs nationalSingle statewide locality.
What it costs in a hospital or surgery center
In a doctor’s office, the office rate above is the whole Medicare payment. When the same procedure is done in a hospital or surgery center, the facility bills its own fee on top of the physician, which is what these totals show. They are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Arizona
Check your ZIP code for local figures across Arizona, from metro Phoenix and Tucson to Flagstaff, Yuma, Prescott, and the rural stretches of the north and southeast.
What psychiatric evaluation costs at hospitals near you
Everything above is a national average. The hospital you pick in Arizona moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 85001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Arizona the office and hospital physician lines for this CPT differ by $34.96.
National vs Arizona
Where Arizona ranks for this CPT
Psychiatric Evaluation and how Arizona is priced
CMS prices all of Arizona through one statewide locality, so Phoenix, Tucson, and the rural counties share a single set of geographic adjustment factors. The state's indices land close to the national average, which makes Arizona a useful benchmark when comparing procedure prices across the country. Because the locality is statewide, the rapid growth of metro Phoenix does not by itself change what Medicare approves there relative to Flagstaff or Yuma. Differences patients notice tend to come from the billing setting and local market conditions, not from the fee schedule.
Arizona has one of the largest Medicare populations in the country thanks to decades of retiree migration, and its winter snowbird influx means demand for care swings by season. Phoenix and Tucson offer deep specialist markets, while much of northern and southeastern Arizona relies on smaller hospitals and long drives for advanced care. Competition among large systems in the Valley gives Phoenix-area patients more room to shop than most rural residents have.
This procedure: A psychiatric diagnostic evaluation is the comprehensive first appointment with a mental health professional, typically a psychologist, therapist, or psychiatrist, covering your history, symptoms, and goals to establish a diagnosis and treatment plan. It usually runs 60 to 90 minutes, longer than ordinary therapy sessions, and happens in an office or by telehealth. This version of the evaluation does not include medical services like prescribing, which distinguishes it from its sister code 90792.
What Is Psychiatric Evaluation?
A psychiatric diagnostic evaluation is the comprehensive first appointment with a mental health professional, typically a psychologist, therapist, or psychiatrist, covering your history, symptoms, and goals to establish a diagnosis and treatment plan. It usually runs 60 to 90 minutes, longer than ordinary therapy sessions, and happens in an office or by telehealth. This version of the evaluation does not include medical services like prescribing, which distinguishes it from its sister code 90792.
What Affects the Cost
- –Many therapists and some psychiatrists do not accept insurance at all, making this a cash purchase at whatever the clinician charges.
- –Clinician credentials drive price: psychiatrists charge more than psychologists, who charge more than masters-level therapists, for the same code.
- –In-network negotiated rates are often far below the clinician's list price, so network status changes the cost more than almost anything else.
- –Telehealth platforms sometimes price intake evaluations differently from their ongoing session rates.
- –Out-of-network plans may reimburse a percentage of an allowed amount well below what the clinician actually charged, leaving you the gap.
Questions to Ask Before Booking
- 1.Are you in network with my plan, and if not, what is your rate for this evaluation?
- 2.Will ongoing sessions be billed at a different rate than this intake?
- 3.If I need medication, will you refer me for a separate 90792 evaluation with a prescriber, at what cost?
- 4.Does my plan offer a network-gap exception if no in-network therapist is available soon?
- 5.Do you provide superbills I can submit for out-of-network reimbursement?
Other featured procedures in Arizona
Psychiatric Evaluation in other states
Psychiatric Evaluation in Arizona: questions
Under 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $172 in Arizona, with no separate facility fee. In a facility the national total is up to about $319 at a hospital outpatient department, because the facility is paid its own rate on top of the physician. Arizona is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Arizona uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $34 for the office physician line or $27 for the hospital physician line in Arizona. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $171.88 is Medicare's whole payment in Arizona: it covers the physician, the room and the supplies, with no separate facility fee. If it is done in a hospital outpatient department instead, the physician is paid about $136.92 and the hospital adds its own facility payment, bringing the national total to up to about $319. Services billed under other codes, such as lab work, are extra. Arizona ranks #24 of 51 states on the office rate (within 2% of the national office rate of $173.35).