Psychiatric Evaluation With Medical Services Cost in Missouri
Psych diag eval w/med srvcs
Missouri Medicare physician rate (2026)
-2.4% vs nationalAverage of 3 localities. Office range $194.00–$199.33.
Your ZIP in Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Missouri the office and hospital physician lines for this CPT differ by $39.23.
National vs Missouri
Where Missouri ranks for this CPT
CPT 90792 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $199.33 |
| metropolitan kansas city | $198.44 |
| rest of missouri | $194.00 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Psychiatric Evaluation With Medical Services and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the state.
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 Missouri
Psychiatric Evaluation With Medical Services in other states
Psychiatric Evaluation With Medical Services in Missouri: questions
How much does psychiatric evaluation with medical services cost in Missouri?
The 2026 Medicare physician office rate for CPT 90792 averages $197.26 across 3 Missouri localities, from $194.00 in REST OF MISSOURI to $199.33 in METROPOLITAN ST. LOUIS. The hospital physician rate averages $158.03. Enter a ZIP for the exact locality.
Does the rate change inside Missouri?
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $5.33 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What will a Medicare patient owe for the physician fee?
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $39 for the office physician line or $32 for the hospital physician line in Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
Is this the full psychiatric evaluation with medical services bill in Missouri?
No. $197.26 is the Medicare physician allowed amount for CPT 90792. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Missouri ranks #17 of 51 states on this physician line (2% below the national office rate of $202.08).