CPT90792

Psychiatric Evaluation With Medical Services Cost in Connecticut

Psych diag eval w/med srvcs

$341Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Connecticut Medicare physician rate (2026)

+4.2% vs national

Single statewide locality.

Connecticut (Hospital)
$164.43
Facility physician fee
Private plan est.
$274–$421
~130–200% of Medicare
Cash / self-pay est.
$168–$316
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Physician fee alone
$159
Only 47% of the hospital total

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 Connecticut

Look up your ZIP code for local detail across Connecticut, including the New Haven and Hartford areas, Fairfield County and Stamford, and the quieter eastern and northwestern corners.

What psychiatric evaluation with medical services costs at hospitals near you

Everything above is a national average. The hospital you pick in Connecticut moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 centre 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 Connecticut the office and hospital physician lines for this CPT differ by $46.04.

National vs Connecticut

National office$202.08
National hospital (physician)$159.32
Connecticut vs national4% above the national office rate of $202.08

Where Connecticut ranks for this CPT

Rank (lowest physician fee first)#44 of 51
Lowest stateArkansas ($191.22)
Highest stateAlaska ($272.73)

Psychiatric Evaluation With Medical Services and how Connecticut is priced

Despite sitting between two of the priciest metros in America, Connecticut is priced as one statewide Medicare locality, with geographic indices well above the national average. Every town from Stamford to Storrs shares the same adjustments, which are pushed up by the state's high wages, rents, and insurance costs. The uniform locality means Fairfield County's proximity to New York does not add a further Medicare premium beyond the statewide level. In practice Connecticut's Medicare-approved amounts rank among the higher states outside the biggest coastal cities.

Connecticut's hospital market has consolidated around a few large systems, and a major academic medical center in New Haven draws complex cases from across the state. Residents of Fairfield County routinely cross into New York for care, while some in the north lean toward Springfield or Boston providers. High commercial prices in the state make Medicare rates and transparent cash pricing especially useful comparison points here.

This procedure: This is the psychiatric diagnostic evaluation performed by a medical provider, a psychiatrist or psychiatric nurse practitioner, that includes medical services: reviewing your health history and medications, considering physical causes of symptoms, and usually prescribing or adjusting psychiatric medication. It typically lasts 45 to 90 minutes as the intake for medication management. Follow-up prescribing visits are then shorter and billed under different codes.

What Is Psychiatric Evaluation With Medical Services?

This is the psychiatric diagnostic evaluation performed by a medical provider, a psychiatrist or psychiatric nurse practitioner, that includes medical services: reviewing your health history and medications, considering physical causes of symptoms, and usually prescribing or adjusting psychiatric medication. It typically lasts 45 to 90 minutes as the intake for medication management. Follow-up prescribing visits are then shorter and billed under different codes.

What Affects the Cost

  • Psychiatrists are among the least likely of all physicians to accept insurance, so cash-pay intake fees are common and vary widely by market.
  • This medical evaluation code pays more than the non-medical 90791, and clinician list prices reflect that.
  • Any labs ordered at intake, such as thyroid or metabolic panels before starting medication, are billed separately by the lab.
  • Follow-up medication visits recur monthly or quarterly indefinitely, so the ongoing cadence matters more than the intake price.
  • Private-pay concierge psychiatry practices bundle intakes and follow-ups into membership pricing outside insurance entirely.

Questions to Ask Before Booking

  • 1.Do you take my insurance, and what are your cash rates for the intake and for follow-ups?
  • 2.How often will I need follow-up visits, and how are those billed?
  • 3.Will you order baseline labs, and where should I have them drawn to stay in network?
  • 4.If therapy is recommended alongside medication, do you provide it or refer out?
  • 5.Can I request a network-gap exception if no in-network prescriber is available in a reasonable time?

Psychiatric Evaluation With Medical Services in Connecticut: questions

Connecticut is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 90792 is $210.47 in an office and $164.43 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Connecticut 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 $42 for the office physician line or $33 for the hospital physician line in Connecticut. Medigap may cover that 20%. This is not the hospital facility fee.

No. $210.47 is only the physician's share. Adding Medicare's facility payment brings the total to about $341 in a hospital outpatient department. Anesthesia, pathology and other codes billed the same day are extra. Connecticut ranks #44 of 51 states on the physician line (4% above the national office rate of $202.08).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.