Psychiatric Evaluation With Medical Services Cost in District of Columbia
Psych diag eval w/med srvcs
$341Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre 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
District of Columbia Medicare physician rate (2026)
+9.1% vs nationalSingle statewide locality.
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.
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 District of Columbia
Enter a ZIP code to see how the DC locality applies to your address, whether you are in the District itself, Bethesda or Silver Spring on the Maryland side, or Arlington and Alexandria in Virginia.
What psychiatric evaluation with medical services costs at hospitals near you
Everything above is a national average. The hospital you pick in District of Columbia 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.
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 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 District of Columbia the office and hospital physician lines for this CPT differ by $50.37.
National vs District of Columbia
Where District of Columbia ranks for this CPT
Psychiatric Evaluation With Medical Services and how District of Columbia is priced
The District of Columbia is unusual in the fee schedule: it forms its own high-cost locality that reaches beyond the city line to cover close-in Maryland and Virginia suburbs, including areas such as Montgomery and Prince George's counties and the Arlington and Alexandria side of the Potomac. Its geographic indices are among the highest in the country, reflecting the region's wages and office costs. As a result, DC-area Medicare-approved amounts run well above those in the rest of Maryland or Virginia, and the boundary of that locality can matter more than the state line. A patient in Bethesda is priced with Washington, not with Baltimore.
The Washington area is dense with hospitals, including multiple academic medical centers and large regional systems competing across the district and its suburbs. That density gives patients real choice within a short distance, which is rare in American health care. Federal employment also means an unusually well-insured population, so cash-pay and Medicare-rate comparisons are most useful for those outside employer coverage.
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?
Other featured procedures in District of Columbia
Psychiatric Evaluation With Medical Services in other states
Psychiatric Evaluation With Medical Services in District of Columbia: questions
District of Columbia is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 90792 is $220.45 in an office and $170.08 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. District of Columbia 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 $44 for the office physician line or $34 for the hospital physician line in District of Columbia. Medigap may cover that 20%. This is not the hospital facility fee.
No. $220.45 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. District of Columbia ranks #50 of 51 states on the physician line (9% above the national office rate of $202.08).