Updated October 4, 2026. Medicare pays $173.35 for CPT 90791 in 2026 (national non-facility). Medicaid fee-for-service ranges from $97.80 (Kentucky) to $334.31 (Alaska) across the 24 jurisdictions we load. UnitedHealthcare state medians run from $143.48 to $181.00. Sources: CMS RVU26D, effective 2026-10-01; state fee schedules verified 2026-09-10; UHC file dated 2026-09-01.
How we got this number: source file dated 2026-09-01. Medicare effective 2026-10-01.
For CPT 90791 (Psychiatric diagnostic evaluation), the CY 2026 Medicare non-facility Physician Fee Schedule amount is $173.35 at GPCI 1.0. Across 53 mapped jurisdictions it ranges from $166.76 to $240.07. Facility national amount: $137.28. Source: CMS RVU26D, October 2026 release, non-QP conversion factor 33.4009, effective 2026-10-01.
Official Medicaid FFS is parsed for Alaska $334.31; Arizona $181.41; California $128.08; District of Columbia $150.61; Florida $134.82; Illinois $122.11; Indiana $162.16; Kentucky $97.80; Louisiana $142.09; Michigan $110.55; Missouri $177.45; Mississippi $150.30; Montana $243.67; North Dakota $194.50; Nebraska $238.40; Nevada $121.15; New York $177.67; Ohio $117.91; Oklahoma $152.97; South Carolina $117.29; Texas $137.93; Virginia $177.22; Washington $127.46; West Virginia $120.78. Other states remain Coming soon. See Methodology and Data Sources.
UnitedHealthcare Optum Behavioral Health professional median for CPT 90791 in Ohio is $153.08 (10th percentile $112.56, 90th percentile $296.21; source file dated 2026-09-01) on /payers/uhc/ohio · Michigan $150.08 · Texas $150.04 · Pennsylvania $156.06 · Illinois $153.24 · Arizona $149.12 · Massachusetts $164.70 · Indiana $150.08 · South Carolina $153.69 · Nebraska $167.43 · Alaska $173.33 · 51 jurisdictions loaded. Aetna and Anthem stay Coming soon.
Last updated
UHC 90791 median by state
UnitedHealthcare medians for CPT 90791 in the 51 jurisdictions in the file dated 2026-09-01. Highest and lowest five shown. Every state is in the UnitedHealthcare state table and the medians CSV.
| State | UHC median | Middle 80% | Official rates |
|---|---|---|---|
| Highest 5 | |||
| Minnesota | $181.00 | $124.55 to $271.56 | Medicare and Medicaid |
| North Dakota | $174.86 | $125.78 to $219.21 | Medicare and Medicaid |
| South Dakota | $173.39 | $133.57 to $234.04 | Medicare and Medicaid |
| Alaska | $173.33 | $129.01 to $338.55 | Medicare and Medicaid |
| Oregon | $170.10 | $107.24 to $281.44 | Medicare and Medicaid |
| Lowest 5 | |||
| Georgia | $148.63 | $95.06 to $216.59 | Medicare and Medicaid |
| Tennessee | $148.63 | $106.93 to $237.43 | Medicare and Medicaid |
| Arkansas | $144.26 | $84.66 to $201.18 | Medicare and Medicaid |
| Kentucky | $144.26 | $106.93 to $206.66 | Medicare and Medicaid |
| Kansas | $143.48 | $100.09 to $204.61 | Medicare and Medicaid |
Commercial percentiles: UnitedHealthcare Optum Behavioral Health is loaded for CPT 90837, 90834, 90832, and 90791 in 51 jurisdictions when that code is in the extract. Aetna, Anthem, Cigna, and Humana stay Coming soon until those files are parsed. Compare a pasted offer on the Contract Checker.
Last verified 2026-09-10. Medicare file effective 2026-10-01. Medicaid effective dates are printed on each cell.
| Jurisdiction | Medicare non-facility | Localities | Medicaid FFS | Commercial | Source |
|---|---|---|---|---|---|
| Alaska | $240.07 | 1 | $334.31 | $173.33 | CMS MPFS |
| Alabama | $167.51 | 1 | Coming soon | $160.00 | CMS MPFS |
| Arkansas | $166.76 | 1 | Coming soon | $144.26 | CMS MPFS |
| Arizona | $171.88 | 1 | $181.41 | $149.12 | CMS MPFS |
| California | $179.49 – $206.78 | 29 | $128.08 | $167.62 | CMS MPFS |
| Colorado | $177.59 | 1 | Coming soon | $150.00 | CMS MPFS |
| Connecticut | $179.48 | 1 | Coming soon | $153.03 | CMS MPFS |
| District of Columbia | $188.26 | 1 | $150.61 | $163.38 | CMS MPFS |
| Delaware | $173.39 | 1 | Coming soon | $159.97 | CMS MPFS |
| Florida | $171.73 – $176.19 | 3 | $134.82 | $148.63 | CMS MPFS |
| Georgia | $168.68 – $174.58 | 2 | Coming soon | $148.63 | CMS MPFS |
| Hawaii | $179.16 | 1 | Coming soon | $161.44 | CMS MPFS |
| Iowa | $169.17 | 1 | Coming soon | $153.94 | CMS MPFS |
| Idaho | $169.44 | 1 | Coming soon | $153.92 | CMS MPFS |
| Illinois | $169.86 – $175.96 | 4 | $122.11 | $153.24 | CMS MPFS |
| Indiana | $169.76 | 1 | $162.16 | $150.08 | CMS MPFS |
| Kansas | $168.75 | 1 | Coming soon | $143.48 | CMS MPFS |
| Kentucky | $168.36 | 1 | $97.80 | $144.26 | CMS MPFS |
| Louisiana | $168.21 – $170.82 | 2 | $142.09 | $149.36 | CMS MPFS |
| Massachusetts | $177.62 – $187.15 | 2 | Coming soon | $164.70 | CMS MPFS |
| Maryland | $175.11 – $178.80 | 2 | Coming soon | $150.00 | CMS MPFS |
| Maine | $169.54 – $172.70 | 2 | Coming soon | $154.55 | CMS MPFS |
| Michigan | $169.57 – $172.25 | 2 | $110.55 | $150.08 | CMS MPFS |
| Minnesota | $174.17 | 1 | Coming soon | $181.00 | CMS MPFS |
| Missouri | $167.20 – $171.22 | 3 | $177.45 | $148.88 | CMS MPFS |
| Mississippi | $167.00 | 1 | $150.30 | $150.08 | CMS MPFS |
| Montana | $173.35 | 1 | $243.67 | $159.46 | CMS MPFS |
| North Carolina | $170.13 | 1 | Coming soon | $152.04 | CMS MPFS |
| North Dakota | $172.95 | 1 | $194.50 | $174.86 | CMS MPFS |
| Nebraska | $169.51 | 1 | $238.40 | $167.43 | CMS MPFS |
| New Hampshire | $175.09 | 1 | Coming soon | $149.71 | CMS MPFS |
| New Jersey | $182.63 – $188.58 | 2 | Coming soon | $149.12 | CMS MPFS |
| New Mexico | $169.80 | 1 | Coming soon | $148.96 | CMS MPFS |
| Nevada | $173.28 | 1 | $121.15 | $151.69 | CMS MPFS |
| New York | $170.93 – $190.53 | 5 | $177.67 | $150.00 | CMS MPFS |
| Ohio | $169.49 | 1 | $117.91 | $153.08 | CMS MPFS |
| Oklahoma | $168.45 | 1 | $152.97 | $150.08 | CMS MPFS |
| Oregon | $172.97 – $180.16 | 2 | Coming soon | $170.10 | CMS MPFS |
| Pennsylvania | $169.67 – $177.61 | 2 | Coming soon | $156.06 | CMS MPFS |
| Puerto Rico | $173.83 | 1 | Coming soon | Coming soon | CMS MPFS |
| Rhode Island | $177.18 | 1 | Coming soon | $157.59 | CMS MPFS |
| South Carolina | $169.87 | 1 | $117.29 | $153.69 | CMS MPFS |
| South Dakota | $172.91 | 1 | Coming soon | $173.39 | CMS MPFS |
| Tennessee | $169.00 | 1 | Coming soon | $148.63 | CMS MPFS |
| Texas | $169.31 – $176.11 | 8 | $137.93 | $150.04 | CMS MPFS |
| Utah | $170.62 | 1 | Coming soon | $150.00 | CMS MPFS |
| Virginia | $172.40 | 1 | $177.22 | $150.74 | CMS MPFS |
| U.S. Virgin Islands | $173.83 | 1 | Coming soon | Coming soon | CMS MPFS |
| Vermont | $172.58 | 1 | Coming soon | $149.33 | CMS MPFS |
| Washington | $177.21 – $189.73 | 2 | $127.46 | $156.06 | CMS MPFS |
| Wisconsin | $171.02 | 1 | Coming soon | $169.32 | CMS MPFS |
| West Virginia | $167.82 | 1 | $120.78 | $156.57 | CMS MPFS |
| Wyoming | $173.18 | 1 | Coming soon | $159.46 | CMS MPFS |
Questions
How much does insurance pay for a 90791 intake?
Medicare: $173.35 national non-facility in 2026. UnitedHealthcare state medians: $143.48 (Kansas) to $181.00 (Minnesota). Texas UHC median: $150.04. Sources: CMS RVU26D, effective 2026-10-01; UHC Transparency in Coverage file dated 2026-09-01.
What does Medicaid pay for 90791?
Across the 24 jurisdictions Parite has parsed, Medicaid FFS for 90791 ranges from $97.80 (Kentucky) to $334.31 (Alaska). Texas is $137.93. Sources: state fee schedules, verified 2026-09-10.
What is the 2026 Medicare rate for CPT 90791?
For CPT 90791 (Psychiatric diagnostic evaluation), the CY 2026 Medicare non-facility Physician Fee Schedule amount is $173.35 at GPCI 1.0 (national). Across mapped localities it ranges from $166.76 to $240.07. Source: CMS RVU26D, October 2026 release, conversion factor 33.4009, effective 2026-10-01.
Which states have official Medicaid FFS amounts for CPT 90791?
Official Medicaid FFS cells are parsed for Alaska $334.31 (eff. 2026-07-01, Alaska Medicaid Physician); Arizona $181.41 (eff. 2026-07-01, AHCCCS FFS Physician); California $128.08 (eff. 2026-08-15, Medi-Cal Rates); District of Columbia $150.61 (eff. 2026-01-01, DHCF DCPFS26001); Florida $134.82 (eff. 2026-01-01, AHCA Practitioner); Illinois $122.11 (eff. 2019-07-01, HFS Practitioner); Indiana $162.16 (eff. 2026-01-01, IHCP Professional); Kentucky $97.80 (eff. 2026-01-01, DMS Physician); Louisiana $142.09 (eff. 2025-07-01, LDH Professional); Michigan $110.55 (eff. 2026-07-01, MDHHS Practitioner); Missouri $177.45 (eff. 2024-01-01, MO HealthNet Behavioral Health); Mississippi $150.30 (eff. 2026-07-01, MS DOM Comprehensive); Montana $243.67 (eff. 2026-07-01, MT DPHHS Physician); North Dakota $194.50 (eff. 2026-08-01, ND Medicaid Professional); Nebraska $238.40 (eff. 2025-07-01, NE DHHS Mental Health); Nevada $121.15 (eff. 2024-01-01, DHCFP PT 20 Physician); New York $177.67 (eff. 2026-07-01, eMedNY Physician); Ohio $117.91 (eff. 2024-01-01, ODM Appendix DD); Oklahoma $152.97 (eff. 2026-07-01, OHCA Title XIX); South Carolina $117.29 (eff. 2024-07-01, SCDHHS Base Physician); Texas $137.93 (eff. 2024-03-01, TMHP Physician); Virginia $177.22 (eff. 2026-07-01, DMAS Procedure Fee); Washington $127.46 (eff. 2026-07-01, HCA Physician-related); West Virginia $120.78 (eff. 2026-04-01, WV BMS RBRVS). Other states stay Coming soon until that state's published file is parsed. Amounts are not blended across age bands or procedure types.
What is the Alaska Medicaid FFS amount for CPT 90791?
Alaska Medicaid FFS for CPT 90791 is $334.31 from Alaska Medicaid Physician, effective 2026-07-01, last verified 2026-09-10. Source: https://extranet-sp.dhss.alaska.gov/hcs/medicaidalaska/Provider/Sites/FeeSchedule.html.
What is the UnitedHealthcare commercial median for CPT 90791 in Ohio?
Ohio CPT 90791 UHC professional median is $153.08 (10th percentile $112.56, 90th percentile $296.21; source file dated 2026-09-01; counted by provider practice state). Michigan median $150.08. Texas median $150.04. Pennsylvania median $156.06. Illinois median $153.24. Arizona median $149.12. Massachusetts median $164.70. Indiana median $150.08. South Carolina median $153.69. Nebraska median $167.43. Alaska median $173.33. Aetna and Anthem stay Coming soon.
Does Parite list Medicaid MCO or commercial rates for CPT 90791?
UnitedHealthcare Optum Behavioral Health percentiles are loaded for CPT 90791 in AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY. Aetna and Anthem stay Coming soon. Medicaid MCO rates stay Coming soon.
When were these CPT 90791 amounts last verified?
Medicare amounts use CMS RVU26D, October 2026 release (released 2026-08-26, effective 2026-10-01 through 2026-12-31). Medicaid FFS last-verified dates are printed on each parsed cell (dataset verified 2026-09-10). See Methodology, Data Sources, and each official source link.
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Related official rates
RVUs used
Work 3.84; non-facility PE 1.33; facility PE 0.25; MP 0.02. CMS short descriptor: Psych diagnostic evaluation.