CPT90792

Psychiatric Evaluation With Medical Services Cost in Texas

Psych diag eval w/med srvcs

$341Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Texas Medicare physician rate (2026)

-0.3% vs national

Average of 8 localities. Office range $196.50–$205.04.

Texas (Hospital)
$159.45
Facility physician fee
Private plan est.
$262–$403
~130–200% of Medicare
Cash / self-pay est.
$161–$302
~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
$159
Only 47% 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 Texas

With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.

What psychiatric evaluation with medical services costs at hospitals near you

Everything above is a national average. The hospital you pick in Texas moves the bill more than anything else you control.

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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 Texas the office and hospital physician lines for this CPT differ by $42.10.

National vs Texas

National office$202.08
National hospital (physician)$159.32
Texas vs nationalwithin 2% of the national office rate of $202.08

Where Texas ranks for this CPT

Rank (lowest physician fee first)#33 of 51
Lowest stateArkansas ($191.22)
Highest stateAlaska ($272.73)

CPT 90792 by Texas locality

LocalityOffice
austin$205.04
houston$204.92
dallas$202.29
galveston$201.81
fort worth$201.79
brazoria$201.42
rest of texas$198.59
beaumont$196.50

PE GPCI ranges from 0.910 to 1.058 in Texas. That index is why the same CPT is not one price statewide.

Psychiatric Evaluation With Medical Services and how Texas is priced

Texas is carved into grouped metro localities rather than priced statewide: Houston, Dallas, Fort Worth, Austin, Galveston, Beaumont, and Brazoria each carry their own locality, and the enormous remainder of the state shares rest-of-state pricing. The big-city localities approve higher amounts than rural Texas, with Houston and Dallas at the top of the state's range. Uniquely, several smaller Gulf Coast areas kept their own localities from an earlier era, which is why Galveston and Beaumont are priced separately from Houston. San Antonio and El Paso, despite their size, fall under rest-of-state factors.

Texas contains several of the largest medical complexes in the world, most famously in Houston, plus deep hospital markets in Dallas-Fort Worth, San Antonio, and Austin. At the other extreme, West Texas and the Panhandle include counties with no physician at all, and rural hospital closures have hit Texas harder than almost any state. Border communities from El Paso to the Rio Grande Valley have distinct markets, and some residents cross into Mexico for lower-cost dental and pharmacy care.

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?

Psychiatric Evaluation With Medical Services in Texas: questions

The 2026 Medicare physician office rate for CPT 90792 averages $201.55 across 8 Texas localities, from $196.50 in BEAUMONT to $205.04 in AUSTIN. The hospital physician rate averages $159.45. Enter a ZIP for the exact locality.

Yes. CMS splits Texas into 8 payment localities. For this CPT the office physician fee spans $8.54 from the lowest to highest locality. With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $40 for the office physician line or $32 for the hospital physician line in Texas. Medigap may cover that 20%. This is not the hospital facility fee.

No. $201.55 is only the physician's share. Adding Medicare's facility payment brings the total to about $341 in a hospital outpatient department. Anesthesia, pathology and other codes billed the same day are extra. Texas ranks #33 of 51 states on the physician line (within 2% of the national office rate of $202.08).

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.