How Much Does a Psychiatric Evaluation With Medical Services Cost in Vermont?
Psych diag eval w/med srvcs
$198.70In-office total2026 Medicare, Vermont averageUnder 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $199 in Vermont, 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
Vermont Medicare physician rate (2026)
-1.7% 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 Vermont
Enter a ZIP code for your part of Vermont, whether Burlington and Chittenden County, Montpelier, Rutland, Brattleboro, or the Northeast Kingdom.
What psychiatric evaluation with medical services costs at hospitals near you
Everything above is a national average. The hospital you pick in Vermont 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 05001.
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 Vermont the office and hospital physician lines for this CPT differ by $42.33.
National vs Vermont
Where Vermont ranks for this CPT
Psychiatric Evaluation With Medical Services and how Vermont is priced
Vermont, with the second-smallest population in the country, is priced as one statewide locality with indices close to the national average, higher than northern New England's rural profile might suggest. Burlington and the smallest Northeast Kingdom towns share the same Medicare-approved amounts. No subdivision has ever been warranted for a state without a single large metro. The fee schedule's simplicity contrasts with the real-world challenge of delivering specialty care across the Green Mountains.
The state's academic medical center in Burlington handles most complex care and also serves northern New York across Lake Champlain, while community hospitals cover the rest of the state with limited procedure menus. Vermonters in the south and east regularly use Dartmouth-area or Boston providers over the border. An aging population, among the oldest in the nation, keeps Medicare central to the state's health economy.
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 Vermont
Psychiatric Evaluation With Medical Services in other states
Psychiatric Evaluation With Medical Services in Vermont: questions
Under 2026 Medicare rates, a psychiatric evaluation with medical services in a doctor's office costs about $199 in Vermont, 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. Vermont is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Vermont 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 $40 for the office physician line or $31 for the hospital physician line in Vermont. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $198.70 is Medicare's whole payment in Vermont: 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 $156.37 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. Vermont ranks #24 of 51 states on the office rate (within 2% of the national office rate of $202.08).