How Much Does a Psychiatric Evaluation With Medical Services Cost in North Carolina?
Psych diag eval w/med srvcs
$196.18In-office total2026 Medicare, North Carolina averageUnder 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $196 in North Carolina, 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.
- ✓Your ZIP's wage-adjusted hospital and surgery center 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
North Carolina Medicare physician rate (2026)
-2.9% vs nationalSingle statewide locality.
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 North Carolina
Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.
What psychiatric evaluation with medical services costs at hospitals near you
Everything above is a national average. The hospital you pick in North Carolina 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 27006.
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 North Carolina the office and hospital physician lines for this CPT differ by $39.89.
National vs North Carolina
Where North Carolina ranks for this CPT
Psychiatric Evaluation With Medical Services and how North Carolina is priced
North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.
North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.
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 North Carolina
Psychiatric Evaluation With Medical Services in other states
Psychiatric Evaluation With Medical Services in North Carolina: questions
Under 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $196 in North Carolina, 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. North Carolina is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. North Carolina 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 $39 for the office physician line or $31 for the hospital physician line in North Carolina. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $196.18 is Medicare's whole payment in North Carolina: 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 $156.29 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. North Carolina ranks #13 of 51 states on the office rate (3% below the national office rate of $202.08).