CPT code 90792: Psychiatric evaluation, with medical services2026 Medicare rate & RVUs

Medicare pays $202.08 for 90792 nationally in the office and $159.32 in a hospital or facility. Local office rates run $191.22–$272.73.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 90792 covers

A psychiatrist or other qualified clinician performs a psychiatric assessment that includes medical services. The work may include reviewing psychiatric and medical history, conducting a mental status examination, forming a diagnostic impression, assessing medication needs, and developing a treatment plan. It is commonly provided in an office or hospital outpatient setting for a patient who needs a diagnostic assessment, including when medication may be part of care.

Select this code when the diagnostic evaluation includes medical services, rather than an evaluation without them. Documentation should support the assessment, findings, diagnostic impression, and medical decisions, including medication-related decisions when made. CMS values the service through physician work, practice expense, and malpractice components; practice expense has separate office and facility valuations. The code represents the diagnostic evaluation, not an ongoing medication follow-up visit.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 90792 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

90792 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 90792 rate is calculated

Each of 90792’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 90792

90792 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

90792 compared with similar codes

How to choose

90791Psychiatric evaluationWithout medical services

Choose 90792 when medical services are part of the psychiatric diagnostic evaluation; choose 90791 when they are not.

90785Interactive complexityCommunication factors

90785 reports qualifying interactive complexity as an add-on; it does not replace the psychiatric diagnostic evaluation.

99204Office visitNew patient, moderate complexity

99204 describes a new-patient office E/M service. Use 90792 when the encounter is a psychiatric diagnostic assessment that includes medical services.

Codes related to 90792

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates