Psychiatric diagnostic evaluation
Medicare pricing data for 60,746 providers across 52 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Psychiatric diagnostic evaluation (HCPCS code 90791) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $148.72, but hospitals typically charge $288.68 — a 1.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $148.72, your out-of-pocket cost would be approximately $29.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $111.80 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $193 | $410 | 91 | 564 | +30.1% |
| New York | $164 | $285 | 5,093 | 55,930 | +10.0% |
| California | $163 | $304 | 4,438 | 67,109 | +9.9% |
| Delaware | $157 | $229 | 251 | 3,702 | +5.5% |
| Puerto Rico | $156 | $221 | 152 | 1,157 | +4.9% |
| New Jersey | $154 | $286 | 2,304 | 44,278 | +3.5% |
| Florida | $152 | $293 | 3,310 | 57,408 | +2.1% |
| Hawaii | $150 | $266 | 209 | 1,015 | +1.0% |
| Pennsylvania | $149 | $262 | 2,672 | 34,936 | +0.3% |
| Arizona | $149 | $307 | 765 | 13,009 | +0.2% |
| Maryland | $149 | $246 | 1,755 | 21,299 | +0.2% |
| Illinois | $148 | $294 | 2,946 | 29,826 | -0.2% |
| Washington | $148 | $341 | 971 | 7,108 | -0.5% |
| Colorado | $147 | $314 | 1,305 | 8,463 | -0.9% |
| Texas | $147 | $277 | 2,558 | 51,668 | -1.2% |
| Massachusetts | $147 | $319 | 3,026 | 26,370 | -1.3% |
| Oregon | $147 | $366 | 894 | 6,215 | -1.3% |
| New Hampshire | $147 | $246 | 411 | 2,954 | -1.4% |
| Connecticut | $146 | $287 | 1,371 | 14,725 | -2.1% |
| West Virginia | $145 | $295 | 288 | 2,707 | -2.5% |
| District of Columbia | $144 | $258 | 160 | 1,316 | -2.9% |
| Oklahoma | $144 | $242 | 467 | 6,081 | -2.9% |
| Nevada | $143 | $326 | 369 | 4,145 | -3.7% |
| Virginia | $143 | $266 | 1,569 | 13,797 | -4.0% |
| Kansas | $143 | $247 | 586 | 5,572 | -4.1% |
| Michigan | $143 | $291 | 3,479 | 25,904 | -4.1% |
| Tennessee | $143 | $325 | 793 | 11,369 | -4.1% |
| Georgia | $142 | $266 | 1,004 | 13,804 | -4.6% |
| South Carolina | $142 | $251 | 601 | 7,882 | -4.6% |
| Missouri | $142 | $266 | 839 | 7,584 | -4.6% |
| New Mexico | $142 | $247 | 468 | 2,968 | -4.8% |
| Wyoming | $141 | $296 | 150 | 1,163 | -5.2% |
| Rhode Island | $141 | $294 | 424 | 3,857 | -5.2% |
| Ohio | $141 | $281 | 2,343 | 20,447 | -5.3% |
| Minnesota | $141 | $377 | 1,992 | 13,956 | -5.4% |
| Wisconsin | $141 | $362 | 1,270 | 8,080 | -5.4% |
| Nebraska | $140 | $308 | 334 | 2,295 | -5.7% |
| North Dakota | $140 | $324 | 263 | 1,772 | -5.8% |
| Indiana | $140 | $258 | 1,240 | 15,571 | -6.2% |
| Mississippi | $138 | $279 | 239 | 2,776 | -7.1% |
| South Dakota | $138 | $230 | 210 | 1,759 | -7.1% |
| Alabama | $137 | $242 | 355 | 3,952 | -8.0% |
| North Carolina | $136 | $289 | 2,125 | 23,935 | -8.3% |
| Utah | $136 | $298 | 527 | 3,676 | -8.4% |
| Louisiana | $136 | $267 | 538 | 3,861 | -8.5% |
| Vermont | $136 | $222 | 267 | 1,495 | -8.7% |
| Arkansas | $135 | $317 | 560 | 6,095 | -9.0% |
| Kentucky | $135 | $289 | 709 | 7,037 | -9.5% |
| Montana | $134 | $239 | 316 | 1,619 | -9.8% |
| Iowa | $133 | $271 | 657 | 4,848 | -10.6% |
| Idaho | $130 | $268 | 404 | 2,705 | -12.7% |
| Maine | $124 | $248 | 643 | 3,189 | -16.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber