How Much Does a Psychiatric Evaluation With Medical Services Cost in New Jersey?
Psych diag eval w/med srvcs
$216.94In-office total2026 Medicare, New Jersey averageUnder 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $217 in New Jersey, from $213 in Rest of New Jersey to $220 in Northern Nj, with no separate facility fee. In a facility the national total is up to about $341 at a hospital outpatient department, because the facility is paid its own rate on top of the physician.
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- ✓The add-on codes that typically land on the bill
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New Jersey Medicare physician rate (2026)
+7.4% vs nationalAverage of 2 localities. Office range $213.47–$220.41.
What it costs in a hospital or surgery center
In a doctor’s office, the office rate above is the whole Medicare payment. When the same procedure is done in a hospital or surgery center, the facility bills its own fee on top of the physician, which is what these totals show. They 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 New Jersey
Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
What psychiatric evaluation with medical services costs at hospitals near you
Everything above is a national average. The hospital you pick in New Jersey 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.
For example 07001.
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 center 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 New Jersey the office and hospital physician lines for this CPT differ by $48.14.
National vs New Jersey
Where New Jersey ranks for this CPT
CPT 90792 by New Jersey locality
| Locality | Office |
|---|---|
| northern nj | $220.41 |
| rest of new jersey | $213.47 |
PE GPCI ranges from 1.092 to 1.160 in New Jersey. That index is why the same CPT is not one price statewide.
Psychiatric Evaluation With Medical Services and how New Jersey is priced
New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.
New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.
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 New Jersey
Psychiatric Evaluation With Medical Services in other states
Psychiatric Evaluation With Medical Services in New Jersey: questions
Under 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $217 in New Jersey, from $213 in Rest of New Jersey to $220 in Northern Nj, with no separate facility fee. In a facility the national total is up to about $341 at a hospital outpatient department, because the facility is paid its own rate on top of the physician. Enter a ZIP for the exact New Jersey locality.
Yes. CMS splits New Jersey into 2 payment localities. For this CPT the office physician fee spans $6.94 from the lowest to highest locality. Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $43 for the office physician line or $34 for the hospital physician line in New Jersey. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $216.94 is Medicare's whole payment in New Jersey: it covers the physician, the room and the supplies, with no separate facility fee. If it is done in a hospital outpatient department instead, the physician is paid about $168.80 and the hospital adds its own facility payment, bringing the national total to up to about $341. Services billed under other codes, such as lab work, are extra. New Jersey ranks #48 of 51 states on the office rate (7% above the national office rate of $202.08).