$169.54–$172.70
Choose 90792 when medical services are part of the psychiatric diagnostic evaluation; choose 90791 when they are not.
On this page
CMS RVU26D · Effective 2026-10-01
90792 Psychiatric evaluation Medicare reimbursement rates in Maine
Report this service for a psychiatric diagnostic assessment that includes medical evaluation, such as assessing medication needs and developing a treatment plan. Compare 90792 office and facility rates across CMS payment localities in Maine.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90792 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$195.33–$199.46
2 of 2 localities have a supported rate.
Facility setting
$156.00–$157.09
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Psychiatry
About 90792: Psychiatric diagnostic evaluation with medical services
Report this service for a psychiatric diagnostic assessment that includes medical evaluation, such as assessing medication needs and developing a treatment plan.
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.
Where the value comes from
- Work RVU4.16 · 69%
- Practice expense (office) RVU1.72 · 28%
- Malpractice RVU0.17 · 3%
554.1K
Medicare services in 2024 · #214 by national volume
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.
90792 compared with similar codes
Office rates for Maine, from the same CMS release.
$14.40–$14.66
90785 reports qualifying interactive complexity as an add-on; it does not replace the psychiatric diagnostic evaluation.
$167.73–$173.66
99204 describes a new-patient office E/M service. Use 90792 when the encounter is a psychiatric diagnostic assessment that includes medical services.
Compare 90792 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$195.33
Facility
$156.00
Southern Maine →
Office / nonfacility
$199.46
Facility
$157.09
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Behavioral health
Compare selected psychiatric diagnostic and individual psychotherapy base rates.
90792 billing questions
How does this differ from 90791?
Use 90792 when the psychiatric diagnostic evaluation includes medical services. Use 90791 for the evaluation without medical services; do not report both for the same assessment.
Does 90792 include medication management?
It can include assessment of medication needs and related medical decisions as part of the diagnostic evaluation. It does not by itself describe a later, ongoing medication follow-up visit.
Can 90785 be reported with 90792?
Yes, when the encounter meets the requirements for interactive complexity. 90785 is an add-on, so report it with the qualifying primary service rather than alone.
Is 90792 selected by visit duration?
No. Selection turns on whether the psychiatric diagnostic evaluation includes medical services, not on a time threshold.
Can a separate E/M service be billed for the same evaluation?
The medical assessment and decisions that are part of the 90792 evaluation are represented by this service. Do not separately report an E/M service for the same work.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,52590759,,Hep b vac 3ag 10mcg 3 dos im,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,52690785,,Psytx complex interactive,A,,0.33,0.11,,0.02,,0.00,0.44,0.35,0,ZZZ,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,52790791,,Psych diagnostic evaluation,A,,3.84,1.33,,0.25,,0.02,5.19,4.11,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,52890792,,Psych diag eval w/med srvcs,A,,4.16,1.72,,0.44,,0.17,6.05,4.77,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,52990832,,Psytx w pt 30 minutes,A,,1.94,0.62,,0.13,,0.01,2.57,2.08,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53090833,,Psytx w pt w e/m 30 min,A,,1.71,0.66,,0.19,,0.07,2.44,1.97,0,ZZZ,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,53190834,,Psytx w pt 45 minutes,A,,2.56,0.83,,0.17,,0.02,3.41,2.75,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00