CPT90791

Psychiatric Evaluation Cost in Nebraska

Psych diagnostic evaluation

$319Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Nebraska Medicare physician rate (2026)

-2.2% vs national

Single statewide locality.

Nebraska (Hospital)
$136.22
Facility physician fee
Private plan est.
$220–$339
~130–200% of Medicare
Cash / self-pay est.
$136–$254
~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
$137
Only 43% 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 Nebraska

Try a ZIP lookup for your part of Nebraska, from Omaha and Lincoln to Grand Island, Kearney, North Platte, Scottsbluff, and the Sandhills.

What psychiatric evaluation costs at hospitals near you

Everything above is a national average. The hospital you pick in Nebraska 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 Nebraska the office and hospital physician lines for this CPT differ by $33.29.

National vs Nebraska

National office$173.35
National hospital (physician)$137.28
Nebraska vs national2% below the national office rate of $173.35

Where Nebraska ranks for this CPT

Rank (lowest physician fee first)#12 of 51
Lowest stateArkansas ($166.76)
Highest stateAlaska ($240.07)

Psychiatric Evaluation and how Nebraska is priced

One locality prices all of Nebraska, with low geographic indices typical of the Plains, so Omaha, Lincoln, and the Sandhills ranch country share the same Medicare-approved amounts. The statewide setup means Nebraska's largest metro carries no fee schedule premium over its most remote village. Practice costs in Omaha do run above the rural average, but CMS averages that into one set of factors. Patients can treat the statewide numbers here as applicable anywhere in Nebraska.

Omaha is the state's medical anchor, with an academic medical center of national standing and a market that also serves western Iowa, while Lincoln adds a second urban hub. Outstate Nebraska depends heavily on critical access hospitals, and residents of the Panhandle often find Denver or Rapid City closer than Omaha for specialty care. Long travel distances are simply part of rural care planning here.

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?

Psychiatric Evaluation in Nebraska: questions

Nebraska is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 90791 is $169.51 in an office and $136.22 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Nebraska 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 Nebraska. Medigap may cover that 20%. This is not the hospital facility fee.

No. $169.51 is only the physician's share. Adding Medicare's facility payment brings the total to about $319 in a hospital outpatient department. Anesthesia, pathology and other codes billed the same day are extra. Nebraska ranks #12 of 51 states on the physician line (2% below the national office rate of $173.35).

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.