CPT90791

How Much Does a Psychiatric Evaluation Cost in Utah?

Psych diagnostic evaluation

$170.62In-office total2026 Medicare, Utah average

Under 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $171 in Utah, 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.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 84001.
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Utah Medicare physician rate (2026)

-1.6% vs national

Single statewide locality.

Utah (Hospital)
$136.71
Facility physician fee
Private plan est.
$222–$341
~130–200% of Medicare
Cash / self-pay est.
$136–$256
~80–150% of Medicare

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.

Physician fee alone
$137
Only 43% 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 Utah

Look up your ZIP for your part of Utah, whether Salt Lake City, Provo, Ogden, Logan, St. George, or the rural east and canyon country.

What psychiatric evaluation costs at hospitals near you

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

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

For example 84001.

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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 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 Utah the office and hospital physician lines for this CPT differ by $33.91.

National vs Utah

National office$173.35
National hospital (physician)$137.28
Utah vs nationalwithin 2% of the national office rate of $173.35

Where Utah ranks for this CPT

Rank (lowest physician fee first)#19 of 51
Lowest stateArkansas ($166.76)
Highest stateAlaska ($240.07)

Psychiatric Evaluation and how Utah is priced

Utah's fee schedule operates as a single statewide locality with geographic indices slightly below the national average, so the Wasatch Front and the remote canyon country share identical Medicare-approved amounts. Salt Lake City's growth into a major regional economy has not split the locality. From Logan to St. George, the same adjustments apply, making the statewide figures a clean guide for any Utah address. As usual, the choice between hospital-based and office-based settings will move a bill more than in-state geography can.

The Wasatch Front from Ogden through Salt Lake City to Provo concentrates nearly all of Utah's specialty care, anchored by an academic medical center and a large integrated system known nationally for cost discipline. Salt Lake City is also the referral hub for a huge intermountain region covering parts of Idaho, Wyoming, and Nevada. Fast-growing St. George serves the southwest corner, but rural and canyon-country residents still travel far for procedures.

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?

Psychiatric Evaluation in Utah: questions

Under 2026 Medicare rates, a psychiatric evaluation in a doctor's office costs about $171 in Utah, 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. Utah is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Utah 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 Utah. Medigap may cover that 20%. This is not the hospital facility fee.

In a doctor's office, $170.62 is Medicare's whole payment in Utah: 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 $136.71 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. Utah ranks #19 of 51 states on the office rate (within 2% of the national office rate of $173.35).

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.