Psychiatric Evaluation Cost in Oregon
Psych diagnostic evaluation
$319Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre 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
Oregon Medicare physician rate (2026)
+1.9% vs nationalAverage of 2 localities. Office range $172.97–$180.16.
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.
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 Oregon
Enter your ZIP code to see whether Portland-area or rest-of-state pricing applies, from Portland and Salem to Eugene, Bend, Medford, the coast, and eastern Oregon.
What psychiatric evaluation costs at hospitals near you
Everything above is a national average. The hospital you pick in Oregon 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.
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 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 Oregon the office and hospital physician lines for this CPT differ by $38.00.
National vs Oregon
Where Oregon ranks for this CPT
CPT 90791 by Oregon locality
| Locality | Office |
|---|---|
| portland | $180.16 |
| rest of oregon | $172.97 |
PE GPCI ranges from 0.996 to 1.111 in Oregon. That index is why the same CPT is not one price statewide.
Psychiatric Evaluation and how Oregon is priced
Oregon splits into a Portland metro locality and a rest-of-state locality, so the fee schedule prices the Willamette Valley's biggest market above Eugene, Bend, Medford, and the rural east. Portland's higher wages and office costs justify the premium, while the rest-of-state locality covers everything from the coast to the high desert at lower adjustments. The two-tier structure means an identical procedure is approved at different amounts on either side of the metro boundary. Oregon's overall indices sit somewhat above the national midpoint, led by the Portland side.
Portland concentrates the state's academic medicine and subspecialty care, drawing patients from all of Oregon and southwest Washington. Bend has grown into a notable central Oregon hub, and Medford serves the southern counties, but the eastern two thirds of the state remains sparsely served, with some residents closer to Boise than to Portland. Coastal communities also face limited local procedure options.
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?
Other featured procedures in Oregon
Psychiatric Evaluation in other states
Psychiatric Evaluation in Oregon: questions
The 2026 Medicare physician office rate for CPT 90791 averages $176.57 across 2 Oregon localities, from $172.97 in REST OF OREGON to $180.16 in PORTLAND. The hospital physician rate averages $138.57. Enter a ZIP for the exact locality.
Yes. CMS splits Oregon into 2 payment localities. For this CPT the office physician fee spans $7.19 from the lowest to highest locality. Enter your ZIP code to see whether Portland-area or rest-of-state pricing applies, from Portland and Salem to Eugene, Bend, Medford, the coast, and eastern Oregon.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $35 for the office physician line or $28 for the hospital physician line in Oregon. Medigap may cover that 20%. This is not the hospital facility fee.
No. $176.57 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. Oregon ranks #40 of 51 states on the physician line (within 2% of the national office rate of $173.35).