How Much Does Psychiatric Diagnostic Evaluation Cost?
Also known as: Psych diagnostic evaluation (CPT 90791)
A comprehensive psychiatric evaluation where a psychiatrist or mental health professional assesses your mental health through a detailed interview.
Psychiatric Diagnostic Evaluation (CPT 90791) costs $137 at Medicare rates.
Patient Guide: Psychiatric Diagnostic Evaluation
What you need to know before your appointment
What to Expect
The psychiatrist will ask detailed questions about your symptoms, personal history, family history, medications, substance use, and daily functioning. They will assess your mood, thinking, and behavior to develop a diagnosis and treatment plan.
How Long Does It Take?
60-90 minutes
Common Reasons Doctors Order This
Depression, anxiety, bipolar disorder, PTSD, ADHD evaluation, medication management, mental health diagnosis
How to Prepare
Write down your symptoms, when they started, and how they affect your life. Bring a list of all medications. Be honest about substance use. Bring insurance information and ID.
Procedures Commonly Done Together
These procedures are frequently performed alongside Psych diagnostic evaluation
How to Reduce Your Cost for Psych diagnostic evaluation
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($173) differs from the facility rate ($137). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (5.19) x CF ($33.40) = $173
Related Procedures
Similar procedures in the same category or body system
People Also Ask
Common questions people search for about this procedure
Is getting a psych evaluation worth it?
Ongoing struggles with attention, learning, emotions, or organization often benefit from a formal evaluation. Psychological evaluations go beyond questionnaires and provide structured, evidence-based answers. Many adults and parents feel relief, not fear, after finally getting diagnostic clarity.
What are the 5 C's of mental health?
What does a full psych evaluation consist of?
How do I get a full mental health assessment?
A GP or nurse may refer you for a mental health assessment. Social care services or educational services also sometimes refer people. You'll have a detailed mental health assessment, which will usually be carried out by a specialist mental health doctor (psychiatrist).
Frequently Asked Questions
How much does Psych diagnostic evaluation cost?
The Medicare facility rate for Psych diagnostic evaluation is $137. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Psych diagnostic evaluation cost without insurance?
Without insurance, the cost of Psych diagnostic evaluation can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Psych diagnostic evaluation?
Most commercial health insurance plans and Medicare cover Psych diagnostic evaluation when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.