CPT90792

Psychiatric Evaluation With Medical Services Cost in Michigan

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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Michigan Medicare physician rate (2026)

-0.6% vs national

Average of 2 localities. Office range $197.81–$203.96.

Michigan (Hospital)
$160.74
Facility physician fee
Private plan est.
$261–$402
~130–200% of Medicare
Cash / self-pay est.
$161–$301
~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 Michigan

Enter your ZIP code to see whether Detroit-area or rest-of-state rates apply, from Detroit, Ann Arbor, and Flint to Grand Rapids, Lansing, Traverse City, and the Upper Peninsula.

What psychiatric evaluation with medical services costs at hospitals near you

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

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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 Michigan the office and hospital physician lines for this CPT differ by $40.15.

National vs Michigan

National office$202.08
National hospital (physician)$159.32
Michigan vs nationalwithin 2% of the national office rate of $202.08

Where Michigan ranks for this CPT

Rank (lowest physician fee first)#30 of 51
Lowest stateArkansas ($191.22)
Highest stateAlaska ($272.73)

CPT 90792 by Michigan locality

LocalityOffice
detroit$203.96
rest of michigan$197.81

PE GPCI ranges from 0.913 to 0.965 in Michigan. That index is why the same CPT is not one price statewide.

Psychiatric Evaluation With Medical Services and how Michigan is priced

Michigan divides into a Detroit metro locality and a rest-of-state locality, so the fee schedule prices southeast Michigan above Grand Rapids, Lansing, and the northern reaches. Detroit's locality reflects the metro's higher wage and cost structure, while everywhere else in the Lower and Upper Peninsulas shares one set of lower adjustments. The result is a simple two-tier state where the main question is whether your care happens inside the Detroit area or out. Upper Peninsula residents, despite their remoteness, price the same as Grand Rapids under the rest-of-state locality.

Southeast Michigan concentrates the state's academic medicine and largest hospital systems, with Ann Arbor's university medical center serving as a top national referral destination. West Michigan has built a strong hospital hub in Grand Rapids, while the Upper Peninsula's small population depends on a few regional hospitals and sometimes crosses into Wisconsin for care. Auto-industry benefit legacies still shape how many Michiganders experience health 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?

Psychiatric Evaluation With Medical Services in Michigan: questions

The 2026 Medicare physician office rate for CPT 90792 averages $200.89 across 2 Michigan localities, from $197.81 in REST OF MICHIGAN to $203.96 in DETROIT. The hospital physician rate averages $160.74. Enter a ZIP for the exact locality.

Yes. CMS splits Michigan into 2 payment localities. For this CPT the office physician fee spans $6.15 from the lowest to highest locality. Enter your ZIP code to see whether Detroit-area or rest-of-state rates apply, from Detroit, Ann Arbor, and Flint to Grand Rapids, Lansing, Traverse City, and the Upper Peninsula.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $40 for the office physician line or $32 for the hospital physician line in Michigan. Medigap may cover that 20%. This is not the hospital facility fee.

No. $200.89 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. Michigan ranks #30 of 51 states on the physician line (within 2% of 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.