How Much Does a Psychiatric Evaluation Cost in South Carolina?
Psych diagnostic evaluation
$169.87In-office total2026 Medicare, South Carolina averageUnder 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $170 in South Carolina, with no separate facility fee. In a facility the national total is up to about $319 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
South Carolina Medicare physician rate (2026)
-2.0% 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 South Carolina
Check your ZIP code for your region of South Carolina, whether Charleston and the Lowcountry, Columbia and the Midlands, Greenville-Spartanburg in the Upstate, or Myrtle Beach and the Grand Strand.
What psychiatric evaluation costs at hospitals near you
Everything above is a national average. The hospital you pick in South 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 29001.
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 South Carolina the office and hospital physician lines for this CPT differ by $33.33.
National vs South Carolina
Where South Carolina ranks for this CPT
Psychiatric Evaluation and how South Carolina is priced
South Carolina prices through one statewide locality with indices a bit below the national average, so Charleston, Columbia, Greenville, and the rural Pee Dee share the same Medicare-approved amounts. Rapid coastal growth has not led CMS to break out a separate locality, keeping the fee schedule uniform from the mountains to the sea islands. The single set of adjustments makes the statewide figures here directly usable anywhere in the state. Facility fees at hospital-owned locations remain the largest source of price variation for patients.
The state's medical firepower splits three ways: an academic medical center and strong hospital market in Charleston, the capital-region systems in Columbia, and a large Upstate network centered on Greenville. Retiree-heavy coastal areas like Hilton Head and Myrtle Beach have booming demand for Medicare-age care, while the rural I-95 corridor faces some of the state's worst access gaps. Some border residents use Charlotte or Augusta providers.
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 South Carolina
Psychiatric Evaluation in other states
Psychiatric Evaluation in South Carolina: questions
Under 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $170 in South Carolina, with no separate facility fee. In a facility the national total is up to about $319 at a hospital outpatient department, because the facility is paid its own rate on top of the physician. South Carolina is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. South 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 $34 for the office physician line or $27 for the hospital physician line in South Carolina. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $169.87 is Medicare's whole payment in South 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 $136.54 and the hospital adds its own facility payment, bringing the national total to up to about $319. Services billed under other codes, such as lab work, are extra. South Carolina ranks #17 of 51 states on the office rate (2% below the national office rate of $173.35).